Optical Coherence Tomography in Children: Analysis of 44 Eyes With Intraocular Tumors and Simulating Conditions

Abstract

Purpose: To investigate the role of optical coherence tomography (OCT) in the evaluation of fundus tumors and simulating lesions in children. Patients and Methods: We report the results of a retrospective single-center case series of 44 eyes of 44 children younger than age 18 with fundus lesions who were evaluated with OCT. In comparison, 12 eyes of 12 children with a normal macula were evaluated with OCT. Main outcome measures were cooperation of children while undergoing OCT and correlation of OCT findings with clinical and ultrasonographic findings Results: The OCT was performed without difficulty in all 56 children. Mean patient age was 12 years (median, 12 years; range, 4 to 17 years). The mean horizontal foveal thickness in the 12 normal eyes was 137 µm (median, 132 µm; range, 109 to 185 µm). Clinical diagnoses included retinoblastoma in 10 (23%) eyes, Coats’ disease in 4 (9%) eyes, retinal capillary hemangioma in 3 (7%) eyes, astrocytic hamartoma of the retina in 3 (7%) eyes, toxocara granuloma in 2 (5%) eyes, and others. OCT was more sensitive than clinical examination in detection of macular pathology including shallow posterior vitreous detachment, surface wrinkling maculopathy, cystoid and noncystoid macular edema, subfoveal fluid, and retinal thinning. In comparison to ultrasonography, OCT was more sensitive in detection of surface wrinkling maculopathy, macular edema, and subfoveal fluid. Ultrasonography was more sensitive in detection of posterior vitreous detachment. Conclusions: OCT is a useful and well-tolerated diagnostic modality for macular evaluation in children. It is more sensitive than clinical examination and ultrasonography in the detection of surface wrinkling maculopathy, macular edema, and subfoveal fluid. J Pediatr Ophthalmol Strabismus 2004;41:338–344.

Review of optical coherence tomography for intraocular tumors

“…Interestingly, the adjacent retina was normal in architecture and seemed to gradually thicken into the disorganized tissue. One might speculate that the tractional component from the epiretinal membrane was the sole source for the distorted retinal findings [35]. Conversely, others have speculated that the epiretinal component could be secondary to the retinal tumor [36].…”

“…Cystoid edema was found in one case. Shields and associates [34,35] reported a series of 11 patients, eight of whom were teenagers or children. They found a distinct epiretinal membrane with secondary retinal folds and striae in nearly all 11 cases [35].…”

“…Shields and associates [34,35] reported a series of 11 patients, eight of whom were teenagers or children. They found a distinct epiretinal membrane with secondary retinal folds and striae in nearly all 11 cases [35]. The membrane showed horizontal traction in all cases and in two cases the membrane was configured in multiple peaks, suggesting vertical traction into the vitreous cavity (Fig.…”

A novel technique using spectral-domain optical coherence tomography (Spectralis, SD-OCT+HRA) to image supine non-anaesthetized infants: utility demonstrated in aggressive posterior retinopathy of prematurity

“…[2][3][4][5] Using a novel modification, we show how the disassembled vertical camera unit of the Spectralis (HRA þ OCT; Heidelberg Engineering, Heidelberg, Germany) allows high-definition spectral-domain (SD) OCT images in four cases of supine premature infants.…”

Optical Coherence Tomography in Congenital Hypertrophy of the Retinal Pigment Epithelium

“…3,5 In combined hamartoma of the retina and RPE, OCT demonstrates an elevated mass with hyperreflectivity in the retina and hyporeflective shadowing of the underlying tissue 6 ; in addition and differently from CHRPE, OCT shows a distinct epiretinal membrane with horizontal traction and secondary retinal folds and striae. 7 Thus, OCT reflects the ultrastructural characteristics of CHRPE and shows different findings in regard to other pigmented lesions of the fundus. This technique is useful in the study of CHRPE, even if the diagnosis is easy and can generally be made by ophthalmoscopic examination.…”