| Title | Long-term visual outcome following chemoreduction for retinoblastoma. | | Author(s) | Demirci H, Shields CL, Meadows AT, Shields JA | | Institution | Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA. | | Source | Arch Ophthalmol 2005 Nov; 123(11):1525-30. | | MeSH | Antineoplastic Combined Chemotherapy Protocols
Carboplatin
Child, Preschool
Combined Modality Therapy
Etoposide
Eye Enucleation
Female
Follow-Up Studies
Humans
Infant
Male
Research Support, Non-U.S. Gov't
Retinal Neoplasms
Retinoblastoma
Retrospective Studies
Treatment Outcome
Vincristine
Visual Acuity
| | Abstract | OBJECTIVE: To evaluate long-term visual outcome following chemoreduction.
DESIGN: Interventional case series evaluating 54 eyes of 40 children with retinoblastoma successfully treated with chemoreduction, consisting of a combination of intravenous carboplatin, etoposide phosphate, and vincristine sulfate plus focal therapy without external beam radiotherapy or enucleation. All patients were followed up for at least 5 years. Patient and tumor data were analyzed for their effect on the main outcome measures (final visual acuities of 20/40 or better and of 20/200 or better) using univariate and multivariate regression models. Patients who failed chemoreduction were excluded.
RESULTS: There were 4 eyes in Reese-Ellsworth group I, 7 in group II, 3 in group III, 15 in group IV, and 25 in group V. The mean distance from the posterior tumor margin to the optic disc was 2 mm, and from the tumor margin to the foveola it was 3 mm. After a mean follow-up of 68 months, 27 eyes (50%) had a final visual acuity of 20/40 or better, and 36 eyes (67%) had final visual acuity of 20/200 or better. Of 33 eyes with macular tumor, only 8 (24%) had a final visual acuity of 20/40 or better, and 15 (45%) had a final visual acuity of 20/200 or better. Of 21 eyes with extramacular tumor, 19 (90%) had a final visual acuity of 20/40 or better, and all (100%) had a final visual acuity of 20/200 or better.
CONCLUSION: The clinical factors that predicted visual acuity of 20/40 or better were a tumor margin at least 3 mm from the foveola and optic disc and an absence of subretinal fluid. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 16286614 |
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