Optical Coherence Tomography (OCT) in Retinoblastoma Management: Experience of the Portuguese National Reference Center
DOI:
https://doi.org/10.48560/rspo.28264Keywords:
Disease Management, Retinoblastoma, Tomography, Optical CoherenceAbstract
INTRODUCTION: Patients under 5 years old with retinoblastoma require close monitoring under anesthesia to ensure early detection of new tumors. They undergo monthly observations after diagnosis and during the first 6 months after treatment, then observations are gradually spaced in time until the age of five. Optical coherence tomography (OCT) is a relatively new exam in monitoring retinoblastoma patients. The advantages include pre-clinical diagnosis of new tumors when located in the posterior pole and evaluation of retinal layers in eyes submitted to intraarterial chemotherapy. We aimed to review the role of handheld OCT in evaluating eyes affected by retinoblastoma and to report our experience using this device.
METHODS: The observational case series included children with retinoblastoma followed at Centro Hospitalar e Universitário de Coimbra from January 2022 to August 2022 who underwent an OCT session during their routine observations under anesthesia. We collected data regarding patients’ age at presentation, family history, RB1 mutation status and International Intraocular Retinoblastoma Classification. The OCT images were analyzed for primary tumor characterization, relapse tumors and associated findings, and correlated to the fundus image on Retcam®.
RESULTS: We included 23 eyes of 19 children that had a total of 44 OCT exams. The median number of OCT scans per eye was 2 (range 1-6). The mean age at presentation of retinoblastoma was 9.37 months old. After reviewing the images, we were able to identify all 4 types of tumor remnants in our series. One patient had a new relapsed tumor that was detected primarily with OCT and treatment was initiated accordingly. In nine eyes, it was impossible to scan the primary tumor due to peripheral localization in the fundus due to advanced stages.
CONCLUSION: Hand-held OCT allows direct visualization of the retina and ensures a closer follow-up of young children with retinoblastoma, leading to the earlier diagnosis of relapses and the ability to treat them with less aggressive options, which may preserve more vision. The use and experience with OCT are increasing in all specialized centers that treat retinoblastoma. Hence, its usefulness will continue to grow and, in the future, there will be more clues to help diagnose retinoblastoma even sooner.
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