Abstract
PurposeTo report on the rate and timing of retinal reattachment and outcomes for retinoblastoma children who have total retinal detachments at presentation to our center and were treated with intra-arterial chemotherapy (ophthalmic artery chemosurgery, OAC).Patients and methodsSingle-center retrospective review of retinoblastoma patients who presented with total retinal detachments and were subsequently treated with OAC at MSKCC between May 2006 and July 2016. Endpoints were retinal detachment resolution, visual function, ERG amplitude, ocular survival, and patient survival from metastases.Results87 eyes of 84 retinoblastoma patients were included. Using a survival multistate model, by 36 months of follow-up, there was a 54% cumulative probability of complete retinal reattachment and a 76% probability of partial reattachment. 24% of eyes that completely reattached received only OAC without any prior or adjuvant treatments. Eyes that completely reattached were significantly more likely to have been diagnosed at a younger age (p<0.0001) and to have greater initial ERG values (p = 0.006). At final follow-up, 14% of eyes had gained at least 25 μV of ERG activity, and 8.0% had achieved hand motion vision or better, including one to 20/60. 13% of eyes were enucleated. No patient died from metastatic disease, and only one developed metastases.ConclusionOAC can successfully treat previously considered “non-salvageable” retinoblastoma eyes with total retinal detachments, promote retinal reattachment in the majority of eyes, and preserve ocular and patient survival.
Highlights
Retinal detachment in eyes of children with retinoblastoma (RB) is common, and for most of the 20th century, these eyes with retinal detachments were routinely treated with enucleation.[1]
Patients were included in our study if they had a diagnosis of retinoblastoma and, at first presentation to our center, were found to have a total retinal detachment on examination and were subsequently treated with Ophthalmic Artery Chemosurgery (OAC) in that eye
We considered bridge chemotherapy to be an extension of OAC
Summary
Retinal detachment in eyes of children with retinoblastoma (RB) is common, and for most of the 20th century (whether disease was unilateral or bilateral), these eyes with retinal detachments were routinely treated with enucleation.[1] While the Reese-Ellsworth classification scheme did not list retinal detachment as a criterion, the majority of eyes seen worldwide were Group V, and those eyes usually had extensive retinal detachments. With the popularization of systemic chemotherapy for intraocular disease, the International Classification of Retinoblastoma was developed.[5] It too did not list total retinal detachment as a criterion, but many of the eyes classified as “D” and most of the “E” eyes have extensive retinal detachments
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call