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1.
Invest Ophthalmol Vis Sci ; 59(13): 5441-5446, 2018 11 01.
Article in English | MEDLINE | ID: mdl-30452597

ABSTRACT

Purpose: To use color Doppler to analyze blood flow in the retrobulbar central retinal artery (CRA) and central retinal vein (CRV) in monocular retinoblastoma. Methods: This prospective study included patients with group D and E retinoblastomas managed with only enucleation. Peak blood velocities were assessed in the CRA and CRV of tumor-containing eyes (CRAv and CRVv, respectively). The resistivity index in the CRA (RIa) and pulse index in the CRV (PIv) were calculated and related to optic nerve invasion (ONi), choroid invasion (mCHi), and tumor volume. RIa and PIv were also calculated for healthy eyes. Results: In total, 25 patients with a mean age of 30.8-months old were included. The means (SD) for CRAv, CRVv, RIa, and PIv were 26.94 (12.32) cm/s, 16.2 (9.56) cm/s, 0.88 (0.12) and 0.79 (0.29), respectively. Tumor volume was significantly correlated with CRAv (P = 0.025) and RIa (P = 0.032). ONi was present in 19 eyes and correlated with a smaller PIv (P < 0.001). A PIv less than 0.935 had a sensitivity of 89.5% and specificity of 83.3% for predicting ONi. mCHi was not correlated with flow values. Healthy eyes had a significantly lower RIa (P < 0.001) and lower PIv than eyes with (P = 0.009) and without (P < 0.001) ONi. Conclusions: In advanced-stage monocular retinoblastoma, tumor volume was directly correlated with CRAv and RIa, and lower PIv was correlated with optic nerve invasion when a predictive cut-off value of less than 0.935 was applied. Comparisons with healthy eyes showed that tumor-containing eyes were associated with higher RIa and PIv values.


Subject(s)
Retinal Artery/physiology , Retinal Neoplasms/physiopathology , Retinal Vein/physiology , Retinoblastoma/physiopathology , Blood Flow Velocity , Child , Child, Preschool , Female , Hemodynamics , Humans , Infant , Magnetic Resonance Imaging , Male , Prospective Studies , Regional Blood Flow/physiology , Retinal Neoplasms/diagnostic imaging , Retinoblastoma/diagnostic imaging , Risk Factors , Ultrasonography, Doppler, Color
2.
Clinics ; 70(12): 797-803, Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-769709

ABSTRACT

OBJECTIVE: To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging. METHODS: A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables. RESULTS: Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p <0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p =0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p =0.675 and p =0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p =0.027). The pulse index in the central retinal vein was lower in male patients (p =0.017) and in eyes with optic nerve invasion (p =0.0088). CONCLUSIONS: TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion.


Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Retinal Artery/physiopathology , Retinal Neoplasms/physiopathology , Retinal Vein/physiopathology , Retinoblastoma/physiopathology , Blood Flow Velocity , Eye Enucleation , Magnetic Resonance Imaging , Neoplasm Invasiveness/pathology , Neoplasm Invasiveness/physiopathology , Optic Nerve Neoplasms/blood supply , Optic Nerve Neoplasms/pathology , Optic Nerve Neoplasms/physiopathology , Prospective Studies , Risk Factors , Retinal Artery/pathology , Retinal Artery , Retinal Neoplasms/blood supply , Retinal Neoplasms/pathology , Retinal Vein/pathology , Retinal Vein , Retinoblastoma/blood supply , Retinoblastoma/pathology , Statistics, Nonparametric , Tumor Burden , Ultrasonography, Doppler, Color/methods
3.
Clinics (Sao Paulo) ; 70(12): 797-803, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26735219

ABSTRACT

OBJECTIVE: To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging. METHODS: A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables. RESULTS: Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p < 0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p = 0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p = 0.675 and p = 0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p = 0.027). The pulse index in the central retinal vein was lower in male patients (p = 0.017) and in eyes with optic nerve invasion (p = 0.0088). CONCLUSIONS: TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion.


Subject(s)
Retinal Artery/physiopathology , Retinal Neoplasms/physiopathology , Retinal Vein/physiopathology , Retinoblastoma/physiopathology , Adolescent , Adult , Aged , Blood Flow Velocity , Child , Eye Enucleation , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Invasiveness/pathology , Neoplasm Invasiveness/physiopathology , Optic Nerve Neoplasms/blood supply , Optic Nerve Neoplasms/pathology , Optic Nerve Neoplasms/physiopathology , Prospective Studies , Retinal Artery/diagnostic imaging , Retinal Artery/pathology , Retinal Neoplasms/blood supply , Retinal Neoplasms/pathology , Retinal Vein/diagnostic imaging , Retinal Vein/pathology , Retinoblastoma/blood supply , Retinoblastoma/pathology , Risk Factors , Statistics, Nonparametric , Tumor Burden , Ultrasonography, Doppler, Color/methods , Young Adult
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