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PHOTO ESSAY |
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Year : 2018 | Volume
: 66
| Issue : 3 | Page : 447-448 |
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Multimodal imaging in a case of retinocytoma
Shreyas Temkar, Amar Pujari, Rohan Chawla, Atul Kumar
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
Date of Submission | 05-Oct-2017 |
Date of Acceptance | 23-Dec-2017 |
Date of Web Publication | 26-Feb-2018 |
Correspondence Address: Dr. Amar Pujari Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Room No 212, Second Floor, RPC-1, New Delhi - 110 029 India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_908_17
Keywords: OCTA, retinocytoma, Swept-source optical coherence tomography
How to cite this article: Temkar S, Pujari A, Chawla R, Kumar A. Multimodal imaging in a case of retinocytoma. Indian J Ophthalmol 2018;66:447-8 |
A 26-year-old female having a history of retinoblastoma with her two children was referred for evaluation. Examination revealed a visual acuity of 20/20 in each eye. The anterior segment was unremarkable in both eyes. Left eye fundus examination revealed a slightly elevated translucent grayish lesion with ill-defined margins in the inferonasal quadrant [Figure 1]a. Right eye examination was within normal limits. | Figure 1: (a) Fundus picture of the left eye showing a well-defined translucent grayish lesion along the inferior and nasal aspect having pigmentary changes along the margin with the underlying visible bare sclera. (b) B-scan ultrasonography of the left eye showing a slightly elevated lesion away from the optic disc with a corresponding high-amplitude spike. (c) Swept-source optical coherence tomography showing an elevated featureless retinal mass over a thinned choroidal layer possessing only deeper large caliber vessels. (d) Fundus fluorescein angiography showing omega-shaped bend with a delayed filling of the retinal veins with window defect. (e) Indocyanine green revealed reduced superficial and deeper choroidal vessels density at the site of the lesion. (f and g) Optical coherence tomography angiography of the choroid revealing complete loss of superficial choriocapillaris with deeper choroidal vessels
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B-scan ultrasonography of the posterior segment revealed a slightly elevated lesion with corresponding high-amplitude reflectivity [Figure 1]b. Swept-source optical coherence tomography (OCT) showed an elevated retinal lesion with an undulating inner surface. The lesion had uniform moderate reflectivity, and none of the layers of the neurosensory retina could be appreciated. The underlying retinal pigment epithelium was visible only in a limited part of the mass and in the rest it appeared atrophic. Underlying choroid was markedly thinned out with only a single layer of vessels seen within it. The chorioscleral interface could be clearly made out [Figure 1]c. Fluorescein angiography highlighted an overlying omega-shaped tortuous vessel with surrounding faint diffuse hyperfluorescence. The underlying larger choroidal vessels were easily visible (window defect) [Figure 1]d. There was no leakage appreciable from or around the mass. Indocyanine green angiography further highlighted the choroidal vessels under and around the lesion [Figure 1]e. OCT-angiography (OCT-A) revealed the presence of intact superficial and deep retinal vascular plexus. The configuration or pattern of these vessels was a bit disorganized, likely due to the mass effect. The mild hyperfluorescence seen in the tumor substance is likely due to these vessels. On deeper segmentation of OCT-A, larger choroidal vessels could also be appreciated due to atrophy of overlying choriocapillaris [Figure 1]f and [Figure 1]g.
Retinocytoma is a benign variant of retinoblastoma.[1] Singh et al. observed the presence of a translucent retinal mass in 21 (88%), calcification in 15 (63%), and retinal pigment epithelial alteration in 13 (54%) of 24 such tumors.[2] Our case revealed a translucent mass with a underlying chorioretinal atrophy.
Conclusion | | |
Noninvasive multimodal imaging in the form of OCT and OCT-A may prove to be useful in following up of patients with retinocytoma
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | | |
1. | Margo C, Hidayat A, Kopelman J, Zimmerman LE. Retinocytoma. A benign variant of retinoblastoma. Arch Ophthalmol 1983;101:1519-31. [ PUBMED] |
2. | Singh AD, Santos CM, Shields CL, Shields JA, Eagle RC Jr. Observations on 17 patients with retinocytoma. Arch Ophthalmol 2000;118:199-205. [ PUBMED] |
[Figure 1]
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