rss
Br J Ophthalmol 2006;90:1168-1172 doi:10.1136/bjo.2006.091223
  • Clinical science
    • Extended reports

Vitreous relapse following primary chemotherapy for retinoblastoma: is adjuvant diode laser a risk factor?

  1. D S Gombos1,2,5,
  2. P A Cauchi1,
  3. J L Hungerford1,2,
  4. P Addison1,
  5. P G Coen4,
  6. J E Kingston1,3
  1. 1Ocular Oncology Service, Bart’s and The London NHS Trust, London, UK
  2. 2Ocular Oncology Service, Moorfields Eye Hospital, London, UK
  3. 3Paediatric Oncology Service, Bart’s and The London NHS Trust, London, UK
  4. 4Academic Department of Child Health, Queen Mary, University of London, UK
  5. 5Section of Ophthalmology, Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
  1. Correspondence to: MrJohn L Hungerford FRCS, Department of Ophthalmology, Ocular Oncology Service, St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, UK; paulcauchi{at}doctors.org.uk
  • Accepted 24 April 2006
  • Published Online First 17 May 2006

Abstract

Aims: To evaluate rates of vitreous relapse among retinoblastoma patients treated with primary chemotherapy and assess diode laser as a potential risk factor for relapse.

Methods: Retrospective review of all patients treated with primary chemotherapy at a large ocular oncology centre. Eyes that developed vitreous relapse were coded with regard to Reese-Ellsworth Group, laterality, time to relapse, type of relapse (vitreous base or non-vitreous base relapse), treatments used (including adjuvant diode laser), and ocular preservation. Individual tumour foci treated with laser hyperthermia were also coded for laser parameters including power settings, number of treatments, and concomitant administration of systemic chemotherapy (chemothermotherapy).

Results: 15 of 106 eyes (14.15%) developed vitreous relapse over a 6 year period. Mean time to relapse was 7.2 months after chemotherapy was completed. Five cases (33%) were of the vitreous base variety. Ocular salvage was attempted in 11 cases using a variety of methods; one patient was lost to follow up. Six of the remaining 10 eyes (60%) were salvaged. Eight of 38 eyes (21%) treated with systemic chemotherapy and laser hyperthermia developed vitreous relapse compared with seven of 68 eyes (10%) treated with primary chemotherapy alone (p<0.005). Laser settings, number of hyperthermia treatments, and the concomitant use of systemic chemotherapy (chemothermotherapy) were not associated with higher rates of vitreous relapse.

Conclusion: Nearly one in seven eyes with retinoblastoma treated with primary chemotherapy may develop vitreous relapse. The administration of diode laser hyperthermia appears to increase this risk. Despite additional therapy a number of these eyes succumb to enucleation.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF
    4. All versions of this article:
      1. bjo.2006.091223v1
      2. 90/9/1168 most recent

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.