Visual prognosis of retinoblastoma in the posterior pole treated with primary chemotherapy plus local treatments

Korean J Ophthalmol. 2010 Dec;24(6):347-52. doi: 10.3341/kjo.2010.24.6.347. Epub 2010 Nov 23.

Abstract

Purpose: To evaluate the visual outcomes of retinoblastoma in the posterior pole (RBPP) treated with chemotherapy plus local treatments and to address the prognostic factors that influence such outcomes.

Methods: The medical records of patients with RBPP diagnosed at the Department of Pediatric Ophthalmology, Seoul National University Children's Hospital between August 1987 and September 2007 were reviewed retrospectively. Only those patients treated via primary chemotherapy plus local treatments were included. The presence of foveal involvement and tumors in the posterior pole before and after treatment, the type of regression pattern and the best corrected visual acuity (BCVA) of each patient were evaluated.

Results: A total of 13 eyes in 12 patients were included. The mean final BCVA for treated RBPP was 20/210 (range, hand motion to 20/16). However, eight eyes (61.5%) had an acuity of 20/200 or better and seven eyes (53.8%) had an acuity of 20/50 or better. The mean final BCVA was significantly better in cases with negative foveal involvement; however, four eyes (37.5%) with positive foveal involvement had an acuity of 20/200 or better. Tumors area in the posterior pole and the type of regression pattern were not significantly related to final BCVA.

Conclusions: Over one half of the studied RBPP patients had working vision. Although the eyes had RBPP with positive foveal involvement, about one-third of the patients had working vision. Vision preservation should be considered when deciding on RBPP treatment.

Keywords: Fovea; Macula; Posterior pole; Prognosis; Retinoblastoma.

MeSH terms

  • Antibiotics, Antineoplastic / administration & dosage
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Etoposide / administration & dosage
  • Eyeglasses
  • Female
  • Follow-Up Studies
  • Fovea Centralis / pathology
  • Humans
  • Infant
  • Male
  • Prognosis
  • Retinal Neoplasms / drug therapy*
  • Retinal Neoplasms / pathology
  • Retinal Neoplasms / physiopathology*
  • Retinoblastoma / drug therapy*
  • Retinoblastoma / pathology
  • Retinoblastoma / physiopathology*
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity

Substances

  • Antibiotics, Antineoplastic
  • Antineoplastic Agents
  • Antineoplastic Agents, Alkylating
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Cisplatin