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S. E. Brodie, Y. Gobin, I. J. Dunkel, J. W. Kim, D. H. Abramson; Persistence of Retinal Function After Selective Ophthalmic Artery Chemotherapy Infusion for Retinoblastoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5020.
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© ARVO (1962-2015); The Authors (2016-present)
To assess retinal survival after chemotherapy for retinoblastoma by selective ophthalmic artery perfusion.
Patients with stage V retinoblastoma were offered selective ophthalmic artery perfusion chemotherapy as an alternative to enucleation under an IRB-approved protocol. Melphalan (and occasionally, carboplatin) were infused directly into the ophthalmic artery after selective cannulation under fluoroscopic control. Patients received up to six infusions. Additional treatment modalities were administered as indicated. Serial ERGs were obtained at monthly examinations under anesthesia.
Infusion chemotherapy has been attempted in 17 cases. In two patients, cannulation of the ophthalmic artery was not possible due to anatomic variations in the origin of the artery. In the 15 treated eyes, dramatic regression of the intraocular tumors was consistently observed. Two eyes (with extinguished ERGs) have been enucleated due to dispersion of vitreal debris which prevented adequate clinical observation. They contained no viable tumor on histopathological examination. ERG data are available for 13 eyes: ERG's were extinguished at the time of the initial ERG study in 4 eyes, apparently due to total retinal detachment; ERGs in these eyes remained extinguished after treatment. In 3 eyes, ERGs improved significantly with treatment; in two cases, ERG's deteriorated after treatment. In 4 eyes, ERGs have been stable after treatment -- in two of these cases with near-normal signals.
Selective ophthalmic artery perfusion chemotherapy for retinoblastoma is compatible with persistence of retinal function; occasional improvement is possible.
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