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ERG monitoring of retinal function during systemic chemotherapy for retinoblastoma
  1. Scott E Brodie1,2,
  2. Yannis M Paulus1,
  3. Mrinali Patel1,
  4. Y Pierre Gobin1,3,
  5. Ira J Dunkel4,
  6. Brian P Marr1,
  7. David H Abramson1
  1. 1Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  2. 2Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York, USA
  3. 3Interventional Neuroradiology Service, Departments of Radiology, Neurosurgery, and Neurology, Weill Cornell Medical College, New York, New York, USA
  4. 4Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  1. Correspondence to Dr Scott E Brodie, Department of Ophthalmology, Box 1183, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029, USA; scott.brodie{at}mssm.edu

Abstract

Background/aims We have previously introduced electroretinography (ERG) as a proxy for visual function to monitor for retinal toxicity due to intra-arterial chemotherapy for retinoblastoma in young children. In this paper, we report ERG results for patients with retinoblastoma receiving initial treatment with systemic chemotherapy.

Methods Inclusion criteria were patients presenting with retinoblastoma at <3 months of age or <6.0 kg in weight, with large tumours not amenable to local laser treatment, cryotherapy or plaque brachytherapy. Patients received intravenous carboplatin 18.7 mg/kg every 3–5 weeks, contingent on recovery of blood counts, until they had grown sufficiently to receive intra-arterial chemotherapy. ERG was performed during examination under anaesthesia at monthly intervals, using contact lens electrodes and a hand-held ganzfeld stimulator. 30-Hertz flicker responses are reported.

Results Four patients were treated for bilateral retinoblastoma. All eyes responded well to systemic chemotherapy. 30-Hertz flicker ERGs improved during treatment in all eyes, significantly in six of eight eyes, and at least in one eye of each patient.

Conclusion Effective systemic chemotherapy for retinoblastoma in children who are too small for intra-arterial chemotherapy is compatible with significant increases in ERG amplitudes, even in eyes presenting with extinguished ERGs. ERG signals may increase independent of resolution of retinal detachment.

  • Retinoblastoma
  • chemotherapy
  • electroretinography
  • carboplatin
  • cancer
  • electrophysiology
  • telemedicine
  • psychophysics
  • optics and refraction
  • retina
  • macula
  • neoplasia
  • iris
  • treatment other
  • conjunctiva
  • ciliary body
  • treatment lasers

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Footnotes

  • Funding This work was supported by the Fund for Ophthalmic Knowledge, Inc. grant no. FFOK 18-11, and by Research to Prevent Blindness. Partial funding was also provided by the Ophthalmic Oncology Center, MSKCC, and departmental support was provided by the Mount Sinai Department of Ophthalmology.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Memorial Sloan-Kettering Cancer Center Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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