Visual outcomes following intraophthalmic artery melphalan for patients with refractory retinoblastoma and age appropriate vision

Tsimpida, Maria; Thompson, Dorothy; Liasis, Alki; Schoch, Monica; Kingston, J. E.; Sagoo, Mandeep S.; Reddy, M. Ashwin

doi:10.1136/bjophthalmol-2013-303694

Cited by 29 publications

(25 citation statements)

References 20 publications

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“…This compares with our initial cohort6 of 12 patients where the average duration was 1 hour 32 min (range from 1 hour to 2 hours 20 min).…”

Section: Resultsmentioning

confidence: 63%

“…All nine patients had age appropriate normal vision6 (tables 2 and 3) at the last follow-up (median follow-up 20.9 months, range 3.7–35.2 months). The assessment of infants can be difficult.…”

Section: Resultsmentioning

confidence: 98%

“…ERGs and VEPs were performed before and after the procedure wherever possible as previously described 6. Pattern and flash VEPs were recorded according to the International Society for Clinical Electrophysiology of Vision (ISCEV) standards12 from three occipital electrodes; O1, Oz and O2 referred as FpZ.…”

Section: Methodsmentioning

confidence: 99%

“…Globe salvage without risk of metastases yet with retained vision would be the goal of any treatment strategy for retinoblastoma. Using thorough orthoptist assessments, age appropriate visual testing in combination with visual evoked potentials (VEPs) and electroretinograms (ERGs) on awake children, we have previously demonstrated that 40% of our earliest cohort developed third nerve palsies5 and 42% of eyes with healthy foveolae had severe visual loss after intra-arterial melphalan 6. We identified high doses of melphalan, catheterisation complications and previous radiotherapy as potential risk factors for visual loss and were interested in how modification of these factors could ameliorate the complications.…”

Section: Introductionmentioning

confidence: 99%

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Reduction of severe visual loss and complications following intra-arterial chemotherapy (IAC) for refractory retinoblastoma

Reddy¹,

Naeem

Duncan

et al. 2017

Br J Ophthalmol

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“…This compares with our initial cohort6 of 12 patients where the average duration was 1 hour 32 min (range from 1 hour to 2 hours 20 min).…”

Section: Resultsmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reduction of severe visual loss and complications following intra-arterial chemotherapy (IAC) for refractory retinoblastoma

Reddy¹,

Naeem

Duncan

et al. 2017

Br J Ophthalmol

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“…Crowded logMAR charts and Snellen acuity were used in older children. If quantitative methods were not possible, qualitative methods were used, namely fixing and following a target or identifying a fixation preference [14]. The results of these routine assessments are the subject of this study.…”

Section: Methodsmentioning

confidence: 99%

The Incidence of Binocular Visual Impairment and Blindness in Children with Bilateral Retinoblastoma

et al. 2018

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Purpose: The study aimed to assess the incidence of and risk factors leading to visual impairment and legal blindness in children with retinoblastoma. Procedures: This is a single-center, retrospective case series of all patients with bilateral retinoblastoma presenting from 2010 to 2014. Results: A total of 44 patients were included in the study. Visual impairment was present in 14 (38%) children, legal blindness was present in 7 (19%) children. Bilateral macular tumors (BMT) were associated with visual impairment (12 of 18 patients with BMT, 2 of 19 patients without BMT, p = 0.0006) and legal blindness (7 of 18 patients with BMT, 0 of 19 patients without BMT, p = 0.003).The International Intraocular Retinoblastoma Classification (IIRC) of the better eye also predicted visual impairment (16% in IIRC Group A–C, 75% in IIRC Group D, E, p = 0.004) and blindness (3% eye in IIRC Group A–C, 50% in Group D, E, p = 0.005). Various non-Snellen visual acuity measures were able to predict visual impairment in pre-verbal children, providing them with early assistance. Conclusions: The rates of visual impairment and blindness reported in this paper can be used to counsel families regarding the risk of binocular visual impairment. Early detection and support for visually impaired infants are essential as development can be affected by severe visual impairment.

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Prospective phase II study of children affected by bilateral intraocular retinoblastoma with macular involvement of both eyes or in the only preserved eye. Macular tumor control, eye preservation rate, and visual outcome

Russo

Lévy-Gabriel

Dupont

et al. 2020

Pediatric Blood & Cancer

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Background: Conservative treatments of intraocular retinoblastoma often consist of chemotherapy and focal treatments. The protocols vary and currently may combine two or three drugs, with different number of cycles, associated to the ocular treatments. In case of macular/paramacular involvement, tumor location and retinal scars induced by focal treatments often have a major negative impact on final visual outcome. Methods: This study aimed to include children affected by bilateral intraocular macular/paramacular retinoblastoma in a prospective phase II study. The protocol consisted of six cycles of a three-drug combination (vincristine, etoposide, carboplatin), and the addition of macula-sparing transpupillary thermotherapy (TTT) to the third cycle. The primary endpoint was the local control rate without external beam radiotherapy (EBR) and/or enucleation. Results: Nineteen patients (26 eyes) were included from July 2004 to November 2009. Thirteen eyes belonged to group V of the Reese-Ellsworth classification and 10 to group D of the International Intraocular Retinoblastoma Classification. Macular/paramacular tumors were treated with chemotherapy alone in nine eyes, and with chemotherapy associated with macula-sparing TTT in 17 eyes. Four eyes experienced macular relapse. At a median follow up of 77 months, 23 eyes (88.5%) were saved

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Visual outcomes following intraophthalmic artery melphalan for patients with refractory retinoblastoma and age appropriate vision

Abstract: Structural and vascular damage to the foveola limited visual acuity. Complications associated with catheterisation and high doses of melphalan may be contributory factors to visual morbidity. Although visual loss is described, no patient developed metastases and most retained good vision.

Cited by 29 publications

References 20 publications

Reduction of severe visual loss and complications following intra-arterial chemotherapy (IAC) for refractory retinoblastoma

Reduction of severe visual loss and complications following intra-arterial chemotherapy (IAC) for refractory retinoblastoma

The Incidence of Binocular Visual Impairment and Blindness in Children with Bilateral Retinoblastoma

Prospective phase II study of children affected by bilateral intraocular retinoblastoma with macular involvement of both eyes or in the only preserved eye. Macular tumor control, eye preservation rate, and visual outcome

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