Introduction: The purpose of this study is to describe variations in microvasculature before and after treatment of treatment-naive lesions and during consolidation therapy of retinoblastoma lesions using an investigational portable optical coherence tomography angiography (OCTA) system. Methods: This study is a single-center, prospective, observational case series. Recruited subjects were either undergoing surveillance for retinoblastoma or had newly detected retinoblastoma. Nine tumors from 7 eyes in 6 patients were included. During exams under anesthesia, the tumors were imaged with an investigational portable OCTA system. OCTA images were analyzed to assess vascular changes before and after treatment. Results: In all 6 presented cases, OCTA imaging revealed distinctive vascular patterns, such as dilated feeder arteries and draining veins, disorganized and complex branching patterns, irregular vessel calibers, and dilation and tortuosity of vessels. After treatment, OCTA imaging revealed decreased intrinsic tumor vascularity and reduced dilation of draining and feeder vessels. Tumor relapse demonstrated prominent vascularity (n = 1) that resolved on repeat OCTA after transpupillary thermotherapy treatment. Type 2 (n = 1), 3 (n = 6), and 4 (n = 1) tumor regression patterns were seen in our patients after treatment, and OCTA findings were consistent with a previously published report. Interestingly, in one of the presented cases, OCTA demonstrated clear feeder, draining, and intrinsic tumor vessels that were not as evident on fluorescein angiography. Conclusions: OCTA may offer a noninvasive and sensitive technique to evaluate the vasculature of both the tumor and the surrounding retina in retinoblastoma. With additional research and development into its use in patients with retinoblastoma, OCTA may one day be useful in assessing treatment response and residual tumor activity.
Ocul Oncol Pathol

中文翻译：

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视网膜母细胞瘤肿瘤治疗前后的光学相干断层扫描血管造影微血管变化

简介：本研究的目的是描述使用研究中的便携式光学相干断层扫描血管造影 (OCTA) 系统在治疗初治病变之前和之后以及在视网膜母细胞瘤病变巩固治疗期间微血管系统的变化。方法：本研究为单中心、前瞻性、观察性病例系列。招募的受试者要么正在接受视网膜母细胞瘤的监测，要么正在新检测到视网膜母细胞瘤。包括来自 6 名患者的 7 只眼睛的 9 个肿瘤。在麻醉下检查期间，使用研究中的便携式 OCTA 系统对肿瘤进行成像。分析 OCTA 图像以评估治疗前后的血管变化。结果：在所有 6 例病例中，OCTA 成像显示了独特的血管模式，例如扩张的支动脉和引流静脉、杂乱无章和复杂的分支模式、不规则的血管口径以及血管的扩张和曲折。治疗后，OCTA 成像显示肿瘤内在血管减少，引流管和支管扩张减少。肿瘤复发表现出显着的血管分布（n = 1），在经瞳孔热疗治疗后重复 OCTA 后得到解决。类型 2 ( n = 1)、3 ( n = 6) 和 4 ( n= 1) 我们的患者在治疗后观察到肿瘤消退模式，OCTA 的发现与先前发表的报告一致。有趣的是，在其中一个病例中，OCTA 显示出清晰的饲养、引流和内在肿瘤血管，这些血管在荧光素血管造影中并不明显。结论： OCTA 可能提供一种无创且敏感的技术来评估视网膜母细胞瘤中肿瘤和周围视网膜的脉管系统。随着对其在视网膜母细胞瘤患者中的应用的进一步研究和开发，OCTA 可能有朝一日可用于评估治疗反应和残余肿瘤活性。
眼肿瘤病理