Korean Journal of Ophthalmology

The Korean Ophthalmological Society (대한안과학회)
권호 표지
DOI QR코드

DOI QR Code

Visual Prognosis of Retinoblastoma in the Posterior Pole Treated with Primary Chemotherapy Plus Local Treatments

  • Kim, Jae-Min (Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Jeong-Hun (Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Seong-Joon (Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Park, Kyung-Duk (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Shin, Hee-Young (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Ahn, Hyo-Seop (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Yu, Young-Suk (Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2010.04.19
  • Accepted : 2010.07.08
  • Published : 2010.12.05
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate the visual outcomes of retinoblastoma in the posterior pole (RBPP) treated with chemotherapy plus local treatments and to address the prognostic factors that influence such outcomes. Methods: The medical records of patients with RBPP diagnosed at the Department of Pediatric Ophthalmology, Seoul National University Children's Hospital between August 1987 and September 2007 were reviewed retrospectively. Only those patients treated via primary chemotherapy plus local treatments were included. The presence of foveal involvement and tumors in the posterior pole before and after treatment, the type of regression pattern and the best corrected visual acuity (BCVA) of each patient were evaluated. Results: A total of 13 eyes in 12 patients were included. The mean final BCVA for treated RBPP was 20/210 (range, hand motion to 20/16). However, eight eyes (61.5%) had an acuity of 20/200 or better and seven eyes (53.8%) had an acuity of 20/50 or better. The mean final BCVA was significantly better in cases with negative foveal involvement; however, four eyes (37.5%) with positive foveal involvement had an acuity of 20/200 or better. Tumors area in the posterior pole and the type of regression pattern were not significantly related to final BCVA. Conclusions: Over one half of the studied RBPP patients had working vision. Although the eyes had RBPP with positive foveal involvement, about one-third of the patients had working vision. Vision preservation should be considered when deciding on RBPP treatment.

Keywords

References

  1. Sanders BM, Draper GJ, Kingston JE. Retinoblastoma in Great Britain 1969-80: incidence, treatment, and survival. Br J Ophthalmol 1988;72:576-83. https://doi.org/10.1136/bjo.72.8.576
  2. Gallie BL, Budning A, DeBoer G, et al. Chemotherapy with focal therapy can cure intraocular retinoblastoma without radiotherapy. Arch Ophthalmol 1996;114:1321-8. https://doi.org/10.1001/archopht.1996.01100140521001
  3. Murphree AL. Retinoblastoma. In: Traboulsi EI, editor. Genetic diseases of the eye. Oxford: Oxford University Press; 1998. p. 813-49.
  4. Murphree AL, Villablanca JG, Deegan WF 3rd, et al. Chemotherapy plus local treatment in the management of intraocular retinoblastoma. Arch Ophthalmol 1996;114:1348-56. https://doi.org/10.1001/archopht.1996.01100140548005
  5. Abramson DH, Gerardi CM, Ellsworth RM, et al. Radiation regression patterns in treated retinoblastoma: 7 to 21 years later. J Pediatr Ophthalmol Strabismus 1991;28:108-12.
  6. Fontanesi J, Pratt CB, Hustu HO, et al. Use of irradiation for therapy of retinoblastoma in children more than 1 year old: the St. Jude Children's Research Hospital experience and review of literature. Med Pediatr Oncol 1995;24:321-6. https://doi.org/10.1002/mpo.2950240510
  7. Yu YS, Kim IH, Ahn HS. Late-onset osteosarcoma in bilateral retinoblastoma survivor. J Korean Ophthalmol Soc 1996;37:1349-53.
  8. Hall LS, Ceisler E, Abramson DH. Visual outcomes in children with bilateral retinoblastoma. J AAPOS 1999;3:138-42. https://doi.org/10.1016/S1091-8531(99)70058-3
  9. Lam BL, Judisch GF, Sobol WM, Blodi CF. Visual prognosis in macular retinoblastomas. Am J Ophthalmol 1990;110:229-32. https://doi.org/10.1016/S0002-9394(14)76335-4
  10. Migdal C. Bilateral retinoblastoma: the prognosis for vision. Br J Ophthalmol 1983;67:592-5. https://doi.org/10.1136/bjo.67.9.592
  11. Weiss AH, Karr DJ, Kalina RE, et al. Visual outcomes of macular retinoblastoma after external beam radiation therapy. Ophthalmology 1994;101:1244-9. https://doi.org/10.1016/S0161-6420(94)31182-1
  12. Desjardins L, Chefchaouni MC, Lumbroso L, et al. Functional results after treatment of retinoblastoma. J AAPOS 2002;6:108-11. https://doi.org/10.1067/mpa.2002.121451
  13. Schefler AC, Cicciarelli N, Feuer W, et al. Macular retinoblastoma: evaluation of tumor control, local complications, and visual outcomes for eyes treated with chemotherapy and repetitive foveal laser ablation. Ophthalmology 2007;114:162-9. https://doi.org/10.1016/j.ophtha.2006.06.042
  14. Singh AD, Garway-Heath D, Love S, et al. Relationship of regression pattern to recurrence in retinoblastoma. Br J Ophthalmol 1993;77:12-6. https://doi.org/10.1136/bjo.77.1.12
  15. Holbek S, Ehlers N. Long-term visual results in eyes cured for retinoblastoma by radiation. Acta Ophthalmol (Copenh) 1989;67:560-6.
  16. Buckley EG, Heath H. Visual acuity after successful treatment of large macular retinoblastoma. J Pediatr Ophthalmol Strabismus 1992;29:103-6.
  17. Lueder GT, Goyal R. Visual function after laser hyperthermia and chemotherapy for macular retinoblastoma. Am J Ophthalmol 1996;121:582-4. https://doi.org/10.1016/S0002-9394(14)75441-8
  18. Shields CL, Mashayekhi A, Cater J, et al. Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors. Am J Ophthalmol 2004;138:329-37. https://doi.org/10.1016/j.ajo.2004.04.032
  19. Shields CL, Palamar M, Sharma P, et al. Retinoblastoma regression patterns following chemoreduction and adjuvant therapy in 557 tumors. Arch Ophthalmol 2009;127:282-90. https://doi.org/10.1001/archophthalmol.2008.626
  20. Watts P, Westall C, Colpa L, et al. Visual results in children treated for macular retinoblastoma. Eye (Lond) 2002;16:75-80. https://doi.org/10.1038/sj.eye.6700070

Cited by

  1. Study on Clinical Therapeutic Effect Including Symptoms, Eye Preservation Rate, and Follow-up of 684 Children with Retinoblastoma vol.23, pp.4, 2010, https://doi.org/10.5301/ejo.5000245
  2. Factors predictive of long-term visual outcomes of Group D eyes treated with chemoreduction and low-dose IMRT salvage: The Children's Hospital Los Angeles experience vol.98, pp.8, 2010, https://doi.org/10.1136/bjophthalmol-2013-304411
  3. Clinical Efficacy and Prognostic Factors of Chemoreduction Combined with Topical Treatment for Advanced Intraocular Retinoblastoma vol.15, pp.18, 2014, https://doi.org/10.7314/apjcp.2014.15.18.7805
  4. Patterns of subretinal fluid resolution in Group D eyes treated with chemoreduction: Experience from the Children’s Hospital Los Angeles/University of Southern California vol.37, pp.4, 2010, https://doi.org/10.3109/13816810.2015.1115881
  5. First-line intra-arterial versus intravenous chemotherapy in unilateral sporadic group D retinoblastoma: evidence of better visual outcomes, ocular survival and shorter time to success with intra-arte vol.101, pp.8, 2010, https://doi.org/10.1136/bjophthalmol-2016-309298
  6. Association of electroretinography with visual outcomes after ophthalmic artery chemosurgery for retinoblastoma in ICRb D and E eyes vol.14, pp.1, 2019, https://doi.org/10.1371/journal.pone.0210647