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Lesley Everett, Joyce Meza, Armin Afshar, Bertil E Damato; Developing a novel documentation system for retinoblastoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3330.
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© ARVO (1962-2015); The Authors (2016-present)
Accurate documentation of eyes with retinoblastoma facilitates treatment and improves research opportunities. The International Retinoblastoma Classification (IRC) stages disease only according to ocular status. However, it must evolve with therapeutic advances and such evolution requires data granularity not provided with current staging. Further, in patients with multiple tumors, IRC staging does not provide sufficient information for safe patient care. The aim of this study was to develop a system for documenting multiple retinoblastomas in the same eye to enhance treatment as well as opportunities for improving disease staging for research.
Retinoblastomas were named according to: ocular location; meridian (in clock minutes); retinal location; status; vitreous seeding; retinal seeding; and treatment. Data was documented prospectively with fundus drawings on an iPad using a customized template, fundus photographs, and customized document flow sheets on our electronic medical record (EMR) system. Data was downloaded into Excel spreadsheets and analyzed using SPSS and Stata.
Forty-one tumors in 29 patients (17 female, 12 male) involved the left eye (13 patients), right eye (5 patients) or both eyes (11 patients). Tumors were located in the macula (16.8%), post-equatorial retina (16.3%), equatorial retina (14.8%), pre-equatorial retina (25.6%) and ora (18.6%) with 6.3% and 1.7% of tumors showing sub-retinal and vitreous seeds, respectively. Documentation was found to be feasible during examinations under anesthesia. Data downloaded from our EMR allowed automated retinal plots, tables, and analyses for individuals and groups of patients.
The UCSF documentation system for retinoblastomas facilitates patient care and should enhance opportunities for multicenter studies aimed at validating and improving the staging of retinoblastoma.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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