Factors correlated to different patterns of regression of retinoblastoma defined by optical coherence tomography

To investigate factors correlated to retinoblastoma regression patterns defined by optical coherence tomography (OCT).

This exploratory cross-sectional study included 33 eyes of 31 cured retinoblastoma patients having 37 regressed tumors using spectral domain OCT. Three reviewers classified OCT patterns, and inter-rater reliability was assessed using Fleiss' kappa. Associations between patterns and demographic and clinical factors were analyzed.

Mean follow-up was 117.2 (± 57.3) months. Inter-rater agreement for pattern assignment was substantial (κ = 0.774). Pattern B was most common (45.9%; 95% CI, 29.4%-63.1%), followed by pattern A (29.7%; 95% CI,15.8%-46.9%) and C (24.3%; 95% CI,11.7%-41.2%). Age was significantly associated with OCT pattern distribution. In patients ≤ 10 years, pattern B predominated (70%), in those > 10 years, pattern A was most frequent (47.1%), then pattern C (35.3%). Pattern C showed greater posterior tumor margin-disc distance than patterns A and B. Initial tumor height differed significantly across patterns, with pattern B showing greater height than pattern C. OCT patterns were significantly associated with clinical regression types. Type I regression predominantly showed pattern B (81.8%) and less frequently pattern A (18.2%). Type II showed equal distribution between patterns A and B. Type III corresponded exclusively to pattern B. Type IV was distributed across patterns A (36.4%), B (22.7%), and C (40.9%). All pattern C tumors were observed with type IV regression. No significant associations were observed with gender, laterality, tumor base diameter, treatment intensity, regression size, or follow-up duration.

Tumor anteroposterior location and initial height showed associations with OCT regression patterns.