Ultrasound biomicroscopy in the management of retinoblastoma.
OBJECTIVE
To determine the role of ultrasound biomicroscopy (UBM) in the management of children affected with retinoblastoma.


METHODS
A review of clinical records of children with the diagnosis of retinoblastoma at the Hospital for Sick Children from January 1995 to December 2007, for whom UBM was used to determine the extent of intraocular tumor. Clinical characteristics were compared with UBM. Pathological correlation was performed for enucleated eyes.


RESULTS
In total, 101 eyes of 75 patients were included in the final analysis. Only 11 eyes were diagnosed on UBM to have extension of the tumor anterior to the ora serrata, and were enucleated. Histopathological examination confirmed the anterior extension in all the 11 eyes. In total, 50 eyes were enucleated because of various reasons, such as poor visual prognosis (12 eyes), unilateral group D or E (23 eyes), recurrences (8 eyes), and treatment failure (7 eyes). None of those patients were found to have anterior extension of the disease on histopathological examination. UBM did not yield any false negative (0/50) or any false positives (0/11).


CONCLUSIONS
The UBM provided a sensitive and reproducible visualization of the anterior retina, ciliary region, and anterior segment allowing a better staging of the advanced disease process. Primary assessment of the true extent of retinoblastoma is critical for the selection of an optimal management approach.
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
L M
LM
Vasquez
G P
GP
Giuliari
W
W
Halliday
C J
CJ
Pavlin
B L
BL
Gallie
E
E
Héon
D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D002924:Ciliary Body / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D033401:Microscopy, Acoustic / Q000379:methods*; D015203:Reproducibility of Results; D012175:Retinoblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity
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