title: Hand-held high-resolution spectral domain optical coherence tomography in retinoblastoma: clinical and morphologic considerations.
abstract: OBJECTIVE
  Hand-held spectral domain optical coherence tomography (HHSD OCT) has greatly expanded the imaging/diagnostic capacity for clinicians managing children with intraocular retinoblastoma. We present our early experience with HHSD OCT and conventional spectral domain OCT imaging in these patients.
  
  
  METHODS
  In this retrospective cross-sectional observational study, infants were imaged during examination under anaesthesia with HHSD OCT in the supine position. Older cooperative retinoblastoma patients were additionally imaged with upright conventional OCT. Clinical data were derived from patient charts and from a prospectively maintained interinstitutional retinoblastoma database. Complementary imaging techniques, including RetCam™, fluorescein angiography and B-scan ultrasound, were assessed.
  
  
  RESULTS
  Twenty-two intraocular lesions in 16 patients were imaged. HHSD OCT was used exclusively in 19 lesions, while conventional OCT was also performed in three cases. Small lesions were imaged in five cases, all of which were localised to the middle retinal layers. Clinical uses for HHSD OCT imaging identified included: diagnosis of new lesions, monitoring response to laser therapy and the identification of edge recurrences.
  
  
  CONCLUSIONS
  Although indirect ophthalmoscopy remains the gold standard for diagnosis and treatment of retinoblastoma, HHSD OCT is a valuable tool in better understanding and managing retinoblastoma.
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 2M9.
authors.forename: Daniel Benson
authors.initials: DB
authors.lastname: Rootman
authors.forename: Efren
authors.initials: E
authors.lastname: Gonzalez
authors.forename: Ashwin
authors.initials: A
authors.lastname: Mallipatna
authors.forename: Cynthia
authors.initials: C
authors.lastname: Vandenhoven
authors.forename: Lindsay
authors.initials: L
authors.lastname: Hampton
authors.forename: Helen
authors.initials: H
authors.lastname: Dimaras
authors.forename: Helen S L
authors.initials: HS
authors.lastname: Chan
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Gallie
authors.forename: Elise
authors.initials: E
authors.lastname: Heon
mesh_terms: D000293:Adolescent; D000328:Adult; D000758:Anesthesia; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007223:Infant; D017075:Laser Coagulation; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D019572:Retinal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D012175:Retinoblastoma / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies; D016683:Supine Position; D041623:Tomography, Optical Coherence / Q000295:instrumentation*; D055815:Young Adult