Clinical and morphometric investigation of retinopathy in children with retinoblastoma treated with chemotherapy

Abstract

PurposeTo analyze the results of clinical and morphometric investigation of retina in children with retinoblastoma treated with systemic and local chemotherapy in comparison with children with primary untreated tumor.Methods55 children (87 eyes) with retinoblastoma treated with systemic chemotherapy, intra‐arterial, intravitreal chemotherapy and 19 patients (38 eyes) with primary tumors before treatment were examined. All patients were examined by ophthalmoscopy using Ret Cam and spectral optical coherence tomography.ResultsAfter systemic chemotherapy fundus examination revealed retinal edema, retinal artery narrowing, focal and/or diffuse choroidal blanching, pigmented foci of small and medium sizes. On tomograms – hyperreflective loop luminal narrowing, a significant decrease in the caliber of retinal blood vessels as compared to the norm of 16 ± 4.1 μm; waviness photoreceptor layer and its destruction. In macula – 42.6% on tomograms – maculopathy, manifested disorganization RPE, cystoid edema, smoothness papillomacular beam forming beak shaped fovea and retinal thickening. In patients treated with primary systemic and intra‐arterial chemotherapy diagnosed increase in retinal vascular caliber up to 116 ± 8.1 μm. The clinical picture after systemic chemotherapy and intavitreal chemotherapy in 14 eyes characterized by atrophy with the formation of small whitish and pigmented lesions. On tomogramms‐ unevenness and destruction of the inner layers of the retina and epiretinal membranes little‐pointedhyperreflective tricks in the inner layers of the retina.ConclusionsThe results of clinical and morphometric studies of the inner shells eyes, arising under the influence of chemotherapeutic agents are of interest in terms of predicting the visual functions of the child after the complete destruction of the tumor.