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Hand-held high-resolution spectral domain optical coherence tomography in retinoblastoma: clinical and morphologic considerations
  1. Daniel Benson Rootman1,2,
  2. Efren Gonzalez1,3,
  3. Ashwin Mallipatna1,4,
  4. Cynthia VandenHoven1,
  5. Lindsay Hampton1,
  6. Helen Dimaras1,2,
  7. Helen S L Chan5,
  8. Brenda L Gallie1,2,6,
  9. Elise Heon1,2
  1. 1Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada
  2. 2Department of Ophthalmology and Vision Sciences, The University of Toronto, Toronto, Canada
  3. 3Surgery Department, Brigham and Women's Hospital, Boston, Massachusetts, USA
  4. 4Department of Pediatric Ophthalmology & Strabismology, Narayana Nethralaya, Bangalore, India
  5. 5Division of Hematology/Oncology, Department of Pediatrics, The University of Toronto, Toronto, Canada
  6. 6Cancer Informatics, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Canada
  1. Correspondence to Dr Elise Heon, Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 2M9; eheon{at}attglobal.net

Abstract

Purpose Hand-held spectral domain optical coherence tomography (HHSD OCT) has greatly expanded the imaging/diagnostic capacity for clinicians managing children with intraocular retinoblastoma. We present our early experience with HHSD OCT and conventional spectral domain OCT imaging in these patients.

Methods In this retrospective cross-sectional observational study, infants were imaged during examination under anaesthesia with HHSD OCT in the supine position. Older cooperative retinoblastoma patients were additionally imaged with upright conventional OCT. Clinical data were derived from patient charts and from a prospectively maintained interinstitutional retinoblastoma database. Complementary imaging techniques, including RetCam™, fluorescein angiography and B-scan ultrasound, were assessed.

Results Twenty-two intraocular lesions in 16 patients were imaged. HHSD OCT was used exclusively in 19 lesions, while conventional OCT was also performed in three cases. Small lesions were imaged in five cases, all of which were localised to the middle retinal layers. Clinical uses for HHSD OCT imaging identified included: diagnosis of new lesions, monitoring response to laser therapy and the identification of edge recurrences.

Conclusions Although indirect ophthalmoscopy remains the gold standard for diagnosis and treatment of retinoblastoma, HHSD OCT is a valuable tool in better understanding and managing retinoblastoma.

  • Child health (paediatrics)
  • Diagnostic tests/Investigation
  • Neoplasia
  • Retina

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