| Summary: | Abstract Background Precise, submillimeter visualization of retinal microstructures is useful for treatment monitoring of retinoblastoma. Herein, we report the use of hand-held optical coherence tomography (HH-OCT) to document a nearly-invisible retinoblastoma and monitor tumor response to transpupillary thermotherapy (TTT). Case presentation A 3-week-old boy was diagnosed with unilateral familial retinoblastoma in the left eye, classified as group B, and treated with intravenous chemoreduction. At 13-month follow-up, the tumor in the left eye was regressed, and evaluation of the right eye revealed a microscopic, nearly invisible tumor measuring 372 µm in thickness and 1.51 mm in basal dimension. The tumor was confirmed on HH-OCT and the diagnosis was changed to bilateral familial retinoblastoma. The new tumor was subsequently treated with TTT and after 1 month, the tumor regressed to an optically dense scar 166 µm in thickness by HH-OCT. Five months after TTT, the scar was clinically flat and measured 73 µm. Conclusions HH-OCT has assumed a significant role in the monitoring of retinoblastoma in children. In this case, imaging with HH-OCT allowed precise localization of the tumor and submillimeter monitoring of treatment response following TTT.
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