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==Overview==
==Overview==
Other diagnostic studies for retinoblastoma include wide-field fundus photography, spectral domain optical coherence tomography, fluorescein angiography and genetic testing. Biopsy, bone marrow aspiration, lumbar puncture and bone scan may be performed to detect metastases of retinoblastoma to outside the eye.
Other [[Diagnosis|diagnostic]] studies for retinoblastoma include [[fluorescein angiography]] and [[electroretinogram]].
 
==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Wide-field fundus photography and spectral domain optical coherence tomography (sdOCT)===
===Fluorescein Angiography===
On wide-field fundus photography and spectral domain optical coherence tomography, retinal tumors may be noted and documented relative to optic nerve and fovea. It may note the presence of exudative retinal detachment, vitreous and subretinal seeding. Spectral domain optical coherence tomography (sdOCT) notes normal or abnormal foveal contour and may be exquisitely sensitive to document marginal tumor recurrence
*This [[Imaging studies|imaging study]] can be used to differentiate retinoblastoma from other [[lesions]].<ref name="Singh2016">{{cite journal|last1=Singh|first1=Arun D.|title=Retinoblastoma: Evaluation and Differential Diagnosis|volume=7|year=2016|pages=91–99|issn=1664-882X|doi=10.1159/000442228}}</ref>
===Biopsy/FNAC===
*[[Fluorescein angiography]] is particularly helpful in differentiating the [[tumor]] from the advanced form of [[Coats disease|Coats’s disease]].
Unlike most other cancers, which need a biopsy to confirm the diagnosis, retinoblastoma can usually be diagnosed by an eye examination and imaging. A biopsy is not needed in many cases because of risk of orbital seeding and metastasis.<ref name="CCS">  Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>
*[[Imaging]] findings associated with the [[diagnosis]] of retinoblastoma include:
===Fluorescein angiography===
**Normal filling of enlarged [[Dilation|dilated]] [[vessels]] entering a hyper- and hypo-[[Fluorescence|fluorescent]] [[tumor]] mass
Fluorescein angiography is a special type of x-ray procedure used to look at blood vessels inside the eye. A special orange dye called fluorescein is used to make blood vessels in the eye visible. The dye is injected into the arm and travels to the blood vessels in the eye. A series of pictures are then taken to:<ref name="CCS">  Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>
*See how the cancer is responding to treatment
*Predict how well a child will see after treatment
===Bone marrow aspiration===
Bone marrow aspiration is not done very often during diagnosis and staging of retinoblastoma. It is usually done only if the optic nerve contains cancer, which suggests that  cancer may have spread outside the eye. It may also be done in patients who undergo enucleation and in whom the tumor is found at the cut section of the optic nerve.<ref name="pmid7977596">{{cite journal| author=Mohney BG, Robertson DM| title=Ancillary testing for metastasis in patients with newly diagnosed retinoblastoma. | journal=Am J Ophthalmol | year= 1994 | volume= 118 | issue= 6 | pages= 707-11 | pmid=7977596 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7977596  }} </ref>
===Lumbar puncture===
A lumbar puncture is not done very often during diagnosis and staging of retinoblastoma. It may be done if the optic nerve or a large portion of the choroid contains cancer, which suggests that there is a risk that cancer has spread outside the eye.<ref name="CCS">  Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>
===Bone scan===
A bone scan is not used very often during the diagnosis and staging of retinoblastoma. It is usually only done if there is reason to believe that the cancer has spread outside the eye.<ref name="CCS">  Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>
===Genetic testing===
Scientists have recently developed genetic tests to tell if there are changes to a gene (gene mutations). Gene testing involves looking at a person’s DNA. A test is done on blood or tissue to search for retinoblastoma 1 (RB1) gene mutations. Genetic testing may also be done in another family member, such as the child’s parents or siblings, especially if there is a family history of retinoblastoma or if the child is found to have a germline mutation. A germline mutation is an RB1 gene mutation that happened in a parent’s egg or sperm before conception (the joining of sperm and egg) and was passed on to the child. The genetic testing do not guide ocular therapy, but the presence of a germinal mutation can be helpful for screening for secondary cancers and family planning.<ref name="CCS">  Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>


===Electroretinogram===
*[[Electroretinogram]] may be helpful in treatment and monitoring of retinoblastoma. It may be used for:<ref name="MarrSingh2015">{{cite journal|last1=Marr|first1=Brian P.|last2=Singh|first2=Arun D.|title=Retinoblastoma: Evaluation and Diagnosis|year=2015|pages=1–11|doi=10.1007/978-3-662-43451-2_1}}</ref>
**Monitoring [[retinal]] function during treatment
**Obtaining information about [[visual]] potential in pre-verbal children
**Observing the effect of treatment [[toxicity]] on [[retinal]] function
==References==
==References==
<references/>
{{reflist|2}}
 
==See also==
*[[Eye cancer]]
*[[Eye examination]]
 
 
{{Nervous tissue tumors}}
 
[[Category:Ophthalmology]]
[[Category:Types of cancer]]
[[Category:hereditary cancers]]
[[Category:Oncology stub]]


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Latest revision as of 23:59, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Other diagnostic studies for retinoblastoma include fluorescein angiography and electroretinogram.

Other Diagnostic Studies

Fluorescein Angiography

Electroretinogram

  • Electroretinogram may be helpful in treatment and monitoring of retinoblastoma. It may be used for:[2]
    • Monitoring retinal function during treatment
    • Obtaining information about visual potential in pre-verbal children
    • Observing the effect of treatment toxicity on retinal function

References

  1. Singh, Arun D. (2016). "Retinoblastoma: Evaluation and Differential Diagnosis". 7: 91–99. doi:10.1159/000442228. ISSN 1664-882X.
  2. Marr, Brian P.; Singh, Arun D. (2015). "Retinoblastoma: Evaluation and Diagnosis": 1–11. doi:10.1007/978-3-662-43451-2_1.