Vision and visual potential for perifoveal retinoblastoma after optical coherence tomographic-guided sequential laser photocoagulation

Soliman, Sameh E.; VandenHoven, Cynthia; MacKeen, Leslie; Gallie, Brenda L.

doi:10.1136/bjophthalmol-2018-312125

Cited by 11 publications

(11 citation statements)

References 34 publications

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“…The data were obtained retrospectively. There authors did not have access to optical coherence tomography images to assess foveal anatomy before and after treatment, something that has been shown to be affected by laser [14]. The patients and eyes in this study were treated by four different retinoblastoma specialists at two different centers.…”

Section: Discussionmentioning

confidence: 99%

“…The addition of laser causes a progressive scar that may affect vision [9], may increase the rate of vitreous recurrence [10], and has been shown to result in orbital recurrence [11]. Conversely, combining thermal laser with systemic chemotherapy increases the rate of tumor control compared to chemotherapy alone [12,13] and recent research suggests that the foveal anatomy can be preserved with foveal-sparing laser even with parafoveal tumors [14]. There have been no clinical trials testing the effectiveness and long term side effect profile of adjuvant laser for the treatment of retinoblastoma [15].…”

Section: Introductionmentioning

confidence: 99%

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Adjuvant use of laser in eyes with macular retinoblastoma treated with primary intravenous chemotherapy

et al. 2020

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BackgroundAdjuvant use of laser with systemic chemotherapy for treatment of retinoblastoma may reduce recurrence rates while also causing local side effects. Information is lacking on the effect of laser on visual outcomes.MethodsA retrospective review of two retinoblastoma centres in the United Kingdom was conducted. Patients were included if there was a macular tumour in at least one eye. Eyes that received chemotherapy alone were compared with eyes that received chemotherapy plus adjuvant laser.ResultsA total of 76 patients and 91 eyes were included in the study. Systemic chemotherapy alone was used in 71 eyes while chemotherapy plus laser was used in 20 eyes. Demographic characteristics of both groups were similar. Macular relapse rates were similar between groups: 22/71 (31%) eyes in chemotherapy group and 9/20 (45%) eyes in laser group (p=0.29). There was no increase in vitreous relapses in the laser group (2/20 eyes), compared with the chemotherapy group 10/71 eyes (p=0.99). Survival analysis demonstrated similar time to first relapse between groups. Final visual acuity was equal between groups with 6/15 or better present in 31.1% of eyes in the chemotherapy group and 37.5% of eyes in the laser group (p=0.76). Presence of tumour at the fovea was predictive of final visual acuity, regardless of treatment group.ConclusionAdjuvant laser in the treatment of retinoblastoma is safe and does not lead to increased rate of vitreous recurrence. Final visual acuity is determined by the presence of tumour at the fovea and not the use of laser.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adjuvant use of laser in eyes with macular retinoblastoma treated with primary intravenous chemotherapy

et al. 2020

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“…Historically, eyes with RB had a guarded prognosis. Recent studies have demonstrated improved visual outcomes 17–23. A study that evaluated visual outcomes in 12 children with macular RB found that 80% of eyes with macular involvement had improvement of visual acuity following occlusion therapy 21.…”

Section: Discussionmentioning

confidence: 99%

<p>Prevalence of refractive errors in children with retinoblastoma</p>

Villegas¹,

Wu²,

Murray³

et al. 2019

OPTH

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Purpose The main purpose of this study was to investigate refractive errors in children with unilateral and bilateral retinoblastoma (RB). Methods An institutional review board–approved consecutive retrospective cohort study was undertaken. Subjects underwent examination under general anesthesia as part of their RB follow-up, which included evaluation by a single pediatric ophthalmologist. Cycloplegic retinoscopy was performed and keratometry data assessed with a handheld Retinomax K Plus 3 keratorefractometer (Righton Ophthalmic Instruments). Results The study included 61 eyes of 37 subjects, with 18 (49%) males and 19 females. Seventeen eyes (28%) had hyperopia with spherical equivalent ≥3 D. Refractive astigmatism ≥1.5 D was present in 32% of all eyes. Nine (38%) subjects had anisometropia ≥2 D. Fifteen (63%) subjects had anisometropia ≥1 D. Conclusion This study reports the high proportion of amblyogenic refractive risk factors in children with RB, both in RB-affected eyes and contralateral normal eyes.

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“…6,9 –11 Even though the current treatment options achieve excellent local tumor control, the final visual outcomes depend on the size and location of the tumor as well as the administration of adjuvant laser TTT in the macular area. 9,10,12,13…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies reported good tumor control using primary IVC without the use of laser treatment, 5 while others advocated the use of IVC for chemoreduction followed by adjuvant laser application to the nonleading edge of the tumor. 6,[9][10][11] Even though the current treatment options achieve excellent local tumor control, the final visual outcomes depend on the size and location of the tumor as well as the administration of adjuvant laser TTT in the macular area. 9,10,12,13 In patients treated with laser TTT for macular RB, the visual acuity (VA) after treatment is reported to be 20/200 or better in 20% to 63% of patients.…”

Section: Introductionmentioning

confidence: 99%

Primary Macular Retinoblastoma: Clinical Presentation and Treatment Outcomes

Chandra

Raval

et al. 2022

Journal of VitreoRetinal Diseases

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Purpose: To describe the clinical features and treatment outcomes in eyes with primary macular retinoblastoma (RB). Methods: Patients with primary macular RB were analyzed. Results: Of 41 patients (47 eyes), 20 (49%) were boys and 21 (51%) were girls. The mean age at diagnosis was 16 months (range, 1-60 months). The RB was bilateral in 6 patients (15%). At presentation, the macula was completely covered with the tumor in 22 eyes (47%) and partially covered with the fovea spared in 13 eyes (28%) and the fovea involved 12 eyes (25%). Based on the International Classification of Intraocular Retinoblastoma, 25 (53%), 15 (32%), and 7 (15%) of tumors were in Group B, Group C, and Group D, respectively. The tumor had exophytic features in 36 eyes (77%). The mean tumor basal diameter was 10.0 mm and the mean thickness, 5.6 mm. Associated features included subretinal seeds (10 eyes; 21%) and surrounding subretinal fluid (16 eyes; 34%). Forty-three eyes (92%) were treated with intravenous chemotherapy, 2 (4%) with intra-arterial chemotherapy, and 2 (4%) with transpupillary thermotherapy. Local tumor control was achieved in 45 eyes (96%), with 33 eyes (70%) showing a type III regression pattern. Over a mean follow-up of 23 months (range, 3-48 months), the macular tumor recurred in 5 eyes (11%), the globe was salvaged in all eyes with associated foveal atrophy (36 eyes; 77%), and 1 patient (2%) died. Conclusions: Macular RB has a good prognosis for globe salvage while vision salvage might be compromised as a result of associated foveal atrophy.

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Vision and visual potential for perifoveal retinoblastoma after optical coherence tomographic-guided sequential laser photocoagulation

Abstract: Anatomical visual potential and functional vision were better in juxtafoveal than foveolar retinoblastoma treated with foveal-sparing laser photocoagulation guided by OCT. The role of amblyopia therapy requires a prospective study.

Cited by 11 publications

References 34 publications

Adjuvant use of laser in eyes with macular retinoblastoma treated with primary intravenous chemotherapy

Adjuvant use of laser in eyes with macular retinoblastoma treated with primary intravenous chemotherapy

<p>Prevalence of refractive errors in children with retinoblastoma</p>

Primary Macular Retinoblastoma: Clinical Presentation and Treatment Outcomes

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