Ocular Oncology and Pathology
Bakal K. · Raval V.R. · Gattu S.K. · Palkonda V.A.R. · Kaliki S.
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Article / Publication Details
Abstract
Purpose: To describe the clinical features and treatment outcomes of primary subretinal seeds (SRS) in patients with intraocular retinoblastoma (RB).
Methods: Descriptive analysis of primary SRS in 47 patients (50 eyes) with RB.
Results: Mean age was 19 months (range, 2–72 months) and 55% (n=26) of the subjects were male. At presentation, the SRS involved two or more quadrants in 88% of eyes. Most seeds appeared yellowish-grey (66%) and round to oval in shape (48%). Two-thirds of SRS were seen posterior to the equator and within 5 mm from the main tumor. Associated features included subretinal fluid in 50 eyes (100%), total retinal detachment in 28 eyes (56%) and vitreous seeds in 20 eyes (40%). Treatment included intravenous chemotherapy (IVC) (n=47; 94%), enucleation (n=2; 4%), and intra-arterial chemotherapy (n=1; 2%). SRS treatment included adjunct use of focal transpupillary thermotherapy and/or cryotherapy (n=20, 40%). Retinal tumor control was achieved in 36 eyes (76%) with 32 eyes (78%) showing a type 3 regression pattern, while SRS completely regressed in 24 (48%) eyes, partially in 15 (30%) and worsened in 2 (4%) eyes. Over a mean follow-up of 30 months (range, 3–68 months), SRS recurrence was noted in 12 eyes (29%), globe salvage was achieved in 39 eyes (78%), and one (4%) patient died of presumed metastasis.
Conclusion: Primary SRS poses a therapeutic challenge during RB treatment. SRS responds moderately to systemic IVC, with one-third cases showing SRS recurrence and one-fifth ultimately requiring enucleation.
S. Karger AG, Basel
Article / Publication Details
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