Clinic analysis of rhegmatogenous retinal detachment secondary to conservative therapy in retinoblastoma patients_Chinese Journal of Ocular Fundus Diseases

Authors：

Ji Xunda , Li Jiakai , Liang Tingyi , Zhu Xiuyu , Cui Xuehao ,  Zhao Peiquan

Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China;

Corresponding author：

Zhao Peiquan, Email: zhaopeiquan@xinhuamed.com.cn

Keywords：

Retinoblastoma; Retinal detachment; Chemotherapy, cancer, regional perfusion; Laser coagulation; Cryotherapy

DOI：

10.3760/cma.j.issn.1005-1015.2019.05.007

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Objective To observe the clinical characteristics of rhegmatogenous retinal detachment (RRD) secondary to conservative therapy in retinoblastoma (RB) patients.Methods A retrospective study. From July 2013 to May 2017, 20 RRD patients (20 eyes) of 456 RB patients (573 eyes) treated in Xinhua Hospital of Shanghai Jiao Tong University School of Medicine were included in the study. Eleven patients (11 eyes) were boy and 9 patients (9 eyes) were girls. Thirteen patients demonstrated bilateral RB and 7 patients had unilateral RB. Average age when diagnosed with RB was 25 months. International Classification of Retinoblastoma groups were C in 1 eye, D in 17 eyes, and E in 2 eyes. These patients received intra-arterial chemotherapy (17 eyes), intravenous chemotherapy (11 eyes), intravitreal chemotherapy (8 eyes), laser (14 eyes) and/or cryotherapy (5 eyes). Twelve patients (12 eyes) received vitreoretinal surgery including vitrectomy (6 eyes) and scleral buckling (7 eyes). The mean follow-up was 39 months. Fundus examination was performed under general anesthesia during comprehensive treatment and follow-up. The time interval of fundus examination varied from 1 to 6 months depending on the stability of the tumor.Results RRD was noted in 20 eyes (3.5%) with RB. Retinal hole was found in 15 eyes (75%). The cause of RRD was atrophic hole in calcified tumor (6 eyes, 30%), cryotherapy-related hole (5 eyes, 25%) and laser-related hole (9 eyes, 45%). Multiple atrophic hole in calcified tumor was noted in 3 eyes. Size of hole smaller than 2 DD was noted in 8 eyes (53%), and larger than 2 DD was noted in 7 eyes (47%). Holes were in posterior (3 eyes), equator (2 eyes) and periphery (10 eyes). Severe proliferated was noted in 1 eye. No tear was found. No bulbar retinal detachment and choroidal detachment was noted. Among 12 eyes who underwent vitreoretinal surgery, reattachment was achieved in 9 eyes (75%). No metastasis was noted.Conclusions Calcified regression of tumor, cryotherapy and laser were main reasons of RRD. Most of the holes are small in diameter and located in the periphery.

Citation： Ji Xunda, Li Jiakai, Liang Tingyi, Zhu Xiuyu, Cui Xuehao, Zhao Peiquan. Clinic analysis of rhegmatogenous retinal detachment secondary to conservative therapy in retinoblastoma patients. Chinese Journal of Ocular Fundus Diseases, 2019, 35(5): 462-464. doi: 10.3760/cma.j.issn.1005-1015.2019.05.007 Copy

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1. Abramson DH, Fabius AW, Francis JH, et al. Ophthalmic artery chemosurgery for eyes with advanced retinoblastoma[J]. Ophthalmic Genet, 2017, 38(1): 16-21. DOI: 10.1080/13816810.2016.1244695.
2. Grossniklaus HE. Retinoblastoma: fifty years of progress. The LXXI Edward Jackson memorial lecture[J]. Am J Ophthalmol, 2014, 158(5): 875-891. DOI: 10.1016/j.ajo.2014.07.025.
3. Suesskind D, Schrader M, Foerster MH, et al. Cataract formation: a possible complication of intra-arterial chemotherapy for retinoblastoma[J]. Eur J Ophthalmol, 2014, 24(3): 449-453. DOI: 10.5301/ejo.5000393.
4. Yousef YA, Manna M, Khalil MB, et al. Surgical repair of rhegmatogenous retinal detachment in eyes harboring active retinoblastoma[J]. Ophthalmic Genet, 2016, 37(3): 314-317. DOI: 10.3109/13816810.2015.1046556.
5. Fabian ID, Reddy A, Sagoo MS. Classification and staging of retinoblastoma[J]. Community Eye Health, 2018, 31(101): 11-13.
6. Baumal CR, Shields CL, Shields JA, et al. Surgical repair of rhegmatogenous retinal detachment after treatment for retinoblastoma[J]. Ophthalmology, 1998, 105(11): 2134-2139. DOI: 10.1016/S0161-6420(98)91139-3.
7. Shields CL, Say EAT, Pefkianaki M, et al. Rhegmatogenous retinal detachment after intraarterial chemotherapy for retinoblastoma: the 2016 Founders Award Lecture[J]. Retina, 2017, 37(8): 1441-1450. DOI: 10.1097/IAE.0000000000001382.
8. Zhao J, Li Q, Wu S, et al. Pars plana vitrectomy and endoresection of refractory intraocular retinoblastoma[J]. Ophthalmology, 2018, 125(2): 320-322. DOI: 10.1016/j.ophtha.2017.10.015.

Chinese Journal of Ocular Fundus Diseases

Clinic analysis of rhegmatogenous retinal detachment secondary to conservative therapy in retinoblastoma patients

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