TY - JOUR T1 - Emerging options in the management of advanced intraocular retinoblastoma JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 848 LP - 849 DO - 10.1136/bjo.2008.154427 VL - 93 IS - 7 AU - Santosh G Honavar Y1 - 2009/07/01 UR - http://bjo.bmj.com/content/93/7/848.abstract N2 - The management of retinoblastoma has undergone a paradigm shift in the recent past. While the focus continues to be on improved survival and long-term safety of treatment modalities, the stress now is on optimisation of vision. A substantial reduction in the frequency of enucleation has occurred in the last few decades—from 96% in 1974 to less than 75% now for unilateral retinoblastoma, and from 68% before 1989 to 44% now for bilateral retinoblastoma.1–4 Similarly, the proportion of cases treated with radiotherapy has sharply decreased from 35% in 1985–1989 to 7% in 2000–2004.5 Concurrently, there has been an increase in the use of alternative eye- and vision-conserving methods of treatment.6–10Chemoreduction with focal consolidation is now extensively used in the primary management of retinoblastoma.6–10 Standard triple drug chemoreduction (Vincristine+Etoposide+Carboplatin) is most effective for tumours without associated subretinal fluid or vitreous seeding.6–10 Success, defined as eye salvage, is reported in 85% of treated patients when the tumour is less advanced (Reese–Ellsworth groups I … ER -