Gündüz Ahmet Kaan, Tetik Diğdem
Department of Ophthalmology, Ankara University, Faculty of Medicine, Ankara, Türkiye.
Private Eye Clinic, Farilya Business Center 8/38, Ufuk Üniversitesi Cad., Çukurambar, Ankara, Türkiye.
Eur J Ophthalmol. 2023 Nov;33(6):2290-2302. doi: 10.1177/11206721231163619. Epub 2023 Mar 20.
To report RetCam fluorescein angiographic (FA) changes and correlation with clinical findings in the follow-up of retinoblastoma (RB) after frontline intravenous chemotherapy and other treatments.
Patients having RB who underwent post-treatment RetCam fundus photography and FA under general anesthesia between February 2020 and February 2022 were retrospectively analyzed.
78 eyes of 70 patients with RB were included. In 55 (70.5%) eyes with type 1, 2 or 3 regression patterns, the main tumor started to show hyperfluorescence in arterial phase in 24 eyes (43.6%), in early venous phase in 24 (43.6%) eyes, and in late venous phase in 7 (12.7%) eyes. Of thirty-six (46.2%) eyes with chorioretinal scars developing after focal treatments (cryotherapy and transpupillary thermotherapy), window defects and visible choroidal vessels were found in all eyes, scleral staining in 10 (27.8%), and gliosis on scar tissue in 8 (22.2%). Vitreous seeds showed hyperfluorescence if they were calcified (6 eyes, 7.7%) and hypofluorescence if non-calcified (11 eyes, 14.1%). Retrohyaloid seeds (11 eyes, 14.1%) were hypo/isofluorescent while subretinal seeds (6 eyes, 7.7%) were hyperfluorescent. Leakage from peripheral retinal vessels was detected in 14 (17.9%) eyes and non-perfusion in 6 (7.7%) eyes.
RetCam wide-angle FA is useful to evaluate the tumor and associated vascular and retinal changes after treatment in RB. Regressed tumors demonstrate later fluorescein uptake in venous phases. Fluorescein angiographic changes in chorioretinal scars include window defects, visibility of choroidal vessels, scleral staining, and leakage from vessels. Retinal vascular leakage and peripheral non-perfusion can be seen in eyes with regressed stable tumors.
报告视网膜母细胞瘤（RB）在一线静脉化疗及其他治疗后的随访中，RetCam荧光素血管造影（FA）的变化及其与临床发现的相关性。
对2020年2月至2022年2月期间接受治疗后在全身麻醉下进行RetCam眼底摄影和FA的RB患者进行回顾性分析。
纳入70例RB患者的78只眼。在55只（70.5%）呈现1型、2型或3型消退模式的眼中，主要肿瘤在动脉期开始出现高荧光的有24只眼（43.6%），在静脉早期的有24只眼（43.6%），在静脉晚期的有7只眼（12.7%）。在36只（46.2%）经局部治疗（冷冻疗法和经瞳孔温热疗法）后出现脉络膜视网膜瘢痕的眼中，所有眼睛均发现窗样缺损和可见的脉络膜血管，10只眼（27.8%）出现巩膜染色，8只眼（22.2%）瘢痕组织出现胶质增生。玻璃体种植体如果钙化则表现为高荧光（6只眼，7.7%），如果未钙化则表现为低荧光（11只眼，14.1%）。视网膜下玻璃体种植体（11只眼，14.1%）表现为低/等荧光，而视网膜下种植体（6只眼，7.7%）表现为高荧光。14只眼（17.9%）检测到周边视网膜血管渗漏，6只眼（7.7%）出现无灌注。
RetCam广角FA有助于评估RB治疗后肿瘤及相关血管和视网膜的变化。消退的肿瘤在静脉期出现较晚的荧光素摄取。脉络膜视网膜瘢痕的荧光素血管造影变化包括窗样缺损、脉络膜血管可见性、巩膜染色和血管渗漏。在消退稳定的肿瘤眼中可见视网膜血管渗漏和周边无灌注。
