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Preservation of retinoblastoma group E eyes with neovascular glaucoma using intravenous chemotherapy: risk factors and outcomes
  1. Raksha Rao1,
  2. Santosh G Honavar2,
  3. Vijayanand Palkonda Reddy1
  1. 1 Ocular Oncology Service, Centre for Sight, Hyderabad, India
  2. 2 National Retinoblastoma Service, Ocular Oncology, Centre for Sight, Hyderabad, India
  1. Correspondence to Dr Santosh G Honavar, National Retinoblastoma Foundation, Ocular Oncology Service, Centre for Sight, Hyderabad 500034, India; santosh.honavar{at}gmail.com

Abstract

Background/aim To report the outcomes of retinoblastoma group E eyes with neovascular glaucoma (NVG) treated conservatively with intravenous chemotherapy and investigate factors associated with eye salvage and secondary enucleation.

Methods This is a retrospective, comparative, interventional case series. The outcome measures were life salvage, eye salvage and vision salvage.

Results Of the 37 eyes managed by intravenous chemotherapy, secondary enucleation was necessary in 21 eyes (group 1) and eye salvage was possible in 16 eyes (group 2). A comparison of both groups revealed significant difference with group 1 demonstrating greater duration of symptoms (18.8 weeks vs 5.4 weeks, p=0.016), greater intraocular pressure (IOP) at presentation (36 mm Hg vs 30 mm Hg, p=0.044), greater increase in corneal diameter (1.52 mm vs 0.50 mm, p=0.013) and the presence of sterile orbital cellulitis (9 vs 1, p=0.023). Further, the risk factors for secondary enucleation by univariate analysis were duration of symptoms >10 weeks (p=0.003), presenting IOP >26 mm Hg (p=0.045), buphthalmos (p=0.014) and sterile orbital cellulitis (p=0.023) and by multivariate analysis were age at presentation >6 months (p=0.012) and buphthalmos (p=0.017). At a mean follow-up of 20.5 months, none of the patients in either group developed systemic metastasis.

Conclusion For retinoblastoma group E eyes presenting with NVG, the chance of eye salvage with intravenous chemotherapy is better when the age at diagnosis is <6 months, duration of symptoms is <10 weeks, IOP is <26 mm Hg, and in the absence buphthalmos and sterile orbital inflammation.

  • retina
  • glaucoma
  • neovascularisation
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Footnotes

  • Contributors All four authors made contributions to conception or design of the work, drafting of the work, revising it critically, approving the final version to be published, and are accountable for all aspects of the work, and ensure the accuracy or integrity of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data sharing statement SGH had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. No conflicting relationship exists for any author.

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