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Julia Sein, Gregg Lueder; Visual outcomes of macular retinoblastoma tumors treated with systemic chemotherapy and repetitive laser ablation. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3677.
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© ARVO (1962-2015); The Authors (2016-present)
Retinoblastoma is the most common intraocular malignancy of childhood. We investigate the functional and anatomical outcomes of focal laser therapy and systemic chemotherapy for macular retinoblastomas.
Retrospective case study of pediatric patients with macular retinoblastoma treated with laser ablation and systemic chemotherapy from July 1990-July 2015 at Washington University School of Medicine/Saint Louis Children’s Hospital. Primary outcome measure was final visual acuity. Patients with less than 6 months of follow-up were excluded.
12 eyes (10 patients) with macular retinoblastomas were treated with systemic chemotherapy and repetitive indirect laser hyperthermia. Mean age of presentation was 9 months (range 1-12 months). The fovea was directly involved in 4 patients, with foveal detachments in 3 of the cases. Using the International Retinoblastoma classification, 7 eyes were stage B, and 4 eyes were stage C, and 1 eye was stage D. The mean follow-up time was 8.31 years. The number of laser applications necessary for regression of tumors was not associated with decreased visual acuity. Cataracts developed in 3 patients. There were no recurrences of tumor in the patients. Final visual acuity outcomes were 20/20-20/50 in 3 eyes, 20/60-20/200 in 4 eyes, and 20/400 or less in 5 eyes. None of the patients developed metastatic disease.
Systemic chemotherapy and diode laser therapy is an effective treatment for retinoblastoma involving the macula, with excellent tumor control and the potential for good visual outcomes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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