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DOI: 10.1148/radiol.2441060456
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(Radiology 2007;244:273-280.)
© RSNA, 2007

Pediatric Imaging

Eye Size in Retinoblastoma: MR Imaging Measurements in Normal and Affected Eyes1

Pim de Graaf, MD, Dirk L. Knol, PhD, Annette C. Moll, MD, PhD, Saskia M. Imhof, MD, PhD, Antoinette Y. N. Schouten-van Meeteren, MD, PhD, and Jonas A. Castelijns, MD, PhD, BSc

1 From the Departments of Radiology (P.d.G., J.A.C.), Clinical Epidemiology and Biostatistics (D.L.K.), Ophthalmology (A.C.M., S.M.I.), and Pediatric Oncology (A.Y.N.S.), VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. Received March 13, 2006; revision requested May 17; revision received June 26; accepted July 19; final version accepted October 4. P.d.G. supported in part by grants from ZonMw (Netherlands Organization for Health Research and Development), 's-Gravenhage, the Netherlands; the ODAS Foundation, Delft, the Netherlands; the National Foundation for the Blind and Visually Impaired, Utrecht, the Netherlands; the Blindenhulp Foundation, 's-Gravenhage, the Netherlands; and the Dutch Eye Fund, grant 2004-23, Utrecht, the Netherlands. Address correspondence to P.d.G. (e-mail: p.degraaf{at}vumc.nl).

Purpose: To evaluate eye size retrospectively by using magnetic resonance (MR) imaging to measure axial length (AL), equatorial diameter (ED), and eye volume (EV) in patients with retinoblastoma and to evaluate the possible effect of retinoblastoma on eye size.

Materials and Methods: Local ethics committee approval was obtained with waiver of informed consent. MR images of 100 patients with retinoblastoma (50 girls, 50 boys; mean age, 19 months; age range, 9 days to 68 months) were scored by one observer (AL, ED, EV, and tumor volume measurements), with a second observer reviewing all measurements. Normal eyes of patients with unilateral retinoblastoma served as controls. Interobserver measurement agreement was evaluated in a random subset of 50 eyes with use of intraclass correlation coefficients. Linear mixed model analysis was used with adjustments for age, laterality, and sex.

Results: Interobserver agreement was good (intraclass correlation coefficients ≥ 0.89). Eyes with retinoblastoma had significantly shorter ALs (95% confidence interval [CI]: –0.57 mm, –0.16 mm; P = .001) and EDs (95% CI: –1.01 mm, –0.66 mm; P < .001) and significantly smaller EVs (95% CI: –336 mm3, –151 mm3; P < .001) than normal eyes. Within patients, a significant negative relationship was found between tumor volume and EV (P < .001).

Conclusion: MR imaging measurements of AL, ED, and EV were significantly smaller in eyes with retinoblastoma than in normal eyes. In addition, in patients with retinoblastoma, the larger the tumor volume, the smaller the eye.

© RSNA, 2007