OSLI Retina

January 2020

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January 2020 · Vol. 51, No. 1 49 lar changes, but normative data and longitudinal im- aging are required to better understand the clinical implication of these changes. It is reasonable to hy- pothesize that persistently engorged feeder vessels or an increase in vascular density over time on OCTA could be a marker of persistent disease activity or tu- mor reactivation. The limitations of this study include a small sam- ple size of five patients and an unavailability of pre- treatment OCTA data. Furthermore, segmentation of the retinal vasculature into the standard superficial and deep vascular complexes was not possible due to obliteration of discernable retinal layers. Full visu- alization of deeper vascular beds was also hindered due to shadowing from calcifications and thickened areas of tumor. Although projection artifact was not noted from larger feeder vessels, it was challenging to discern whether there was projection artifact from the lacy fine intrinsic vasculature. Additional limitations pertain to the technical aspects of portable OCTA im- age acquisition. Owing to the limited field of view, OCTA acquisition was confined to small, posterior tumors or only portions of larger or more peripheral tumors. Lubrication of the corneal surface and elimi- nation of any movements was needed for image ac- quisition. Overall, OCTA evaluation of eyes with retinoblas- toma may help better understand the intrinsic micro- vascular response to chemoreduction and consolida- tion and may become a useful adjunct in monitoring disease activity. REFERENCES 1. Abramson DH, Shields CL, Munier FL, Chantada GL. Treatment of Retinoblastoma in 2015: Agreement and Disagreement. JAMA Oph- thalmol. 2015;133(11):1341-1347. https://doi.org/10.1001/jamaoph- thalmol.2015.3108 PMID:26378747 2. Rootman DB, Gonzalez E, Mallipatna A, et al. Hand-held high- resolution spectral domain optical coherence tomography in retinoblastoma: clinical and morphologic considerations. Br J Ophthalmol. 2013;97(1):59-65. https://doi.org/10.1136/bjophthal- mol-2012-302133 PMID:23104902 3. Seider MI, Grewal DS, Mruthyunjaya P. Portable Optical Coher- ence Tomography Detection or Confirmation of Ophthalmoscopi- cally Invisible or Indeterminate Active Retinoblastoma. Ophthal- mic Surg Lasers Imaging Retina. 2016;47(10):965-968. https://doi. org/10.3928/23258160-20161004-12 PMID:27759865 4. Finn AP, House RJ, Hsu ST, et al. Hyperreflective Vitreous Opacities on Optical Coherence Tomography in a Patient With Bilateral Reti- noblastoma. Ophthalmic Surg Lasers Imaging Retina. 2019;50(1):50-52. https://doi.org/10.3928/23258160-20181212-08 PMID:30640396 5. Shields JA, Sanborn GE, Augsburger JJ, Orlock D, Donoso LA. Fluo- rescein angiography of retinoblastoma. Trans Am Ophthalmol Soc. 1982;80:98-112. PMID:6892130 6. Ohnishi Y, Yamana Y, Minei M, Ibayashi H. Application of fluorescein angiography in retinoblastoma. Am J Ophthalmol. 1982;93(5):578-588. https://doi.org/10.1016/S0002-9394(14)77372-6 PMID:6177245 7. Bianciotto C, Shields CL, Iturralde JC, Sarici A, Jabbour P, Shields JA. Fluorescein angiographic findings after intra-arterial chemotherapy for retinoblastoma. Ophthalmology. 2012;119(4):843-849. https://doi. org/10.1016/j.ophtha.2011.09.040 PMID:22137042 8. Rössler J, Dietrich T, Pavlakovic H, et al. Higher vessel densities in retinoblastoma with local invasive growth and metastasis. Am J Pathol. 2004;164(2):391-394. https://doi.org/10.1016/S0002- 9440(10)63129-X PMID:14742245 9. House RJ, Hsu ST, Thomas AS, et al. Vascular Findings in a Small Retinoblastoma Tumor Using OCT Angiography. Ophthalmol Reti- na. 2019;3(2):194-195. https://doi.org/10.1016/j.oret.2018.09.018 PMID:31014771 10. Hsu ST, Chen X, Ngo HT, et al. Imaging Infant Retinal Vasculature with OCT Angiography. Ophthalmol Retina. 2019;3(1):95-96. https:// doi.org/10.1016/j.oret.2018.06.017 PMID:30935662

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