Watts P, Westall C, Colpa L, MacKeen L, Abdolell M, Gallie B, Héon E
Department of Ophthalmology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Eye (Lond). 2002 Jan;16(1):75-80. doi: 10.1038/sj.eye.6700070.
To evaluate the results of patching treatment in children with macular retinoblastoma in one eye.
Fifteen children affected by macular retinoblastoma received instructions for patching treatment for amblyopia. Data were collected on age at diagnosis of the tumor, presence of unilateral or bilateral disease, area of posterior pole involvement by the scar of the regressed tumor and its relationship to the fovea; and the onset, duration, and compliance of patching. The visual acuities recorded were expressed in logMAR (logarithm minimum angle of resolution) equivalents.
Twelve children (80%) had bilateral retinoblastoma with the macular involved in one eye and three children had unilateral macular tumors. The median age at which patching was initiated was 15 months (range 4-36). Compliance to patching was good in 80% of children, with a median duration of 4 h (range 0.5-8) per day, 7 days per week, with total occlusion of the better eye. The median percentage of posterior pole involvement was 34% (range 11-100%). Eighty percent of children had some improvement in their visual acuity, and of the children in whom final logMAR acuity was recorded, 73% had an acuity of 1.0 logMAR or better and 53% an acuity of 0.5 logMAR or better after patching. There was no evidence of association between age of patient, sex, duration of patching, or percentage of posterior pole involvement and the improvement in visual acuity.
In spite of the macular involvement of eyes with retinoblastoma, some visual recovery was achieved in 80% of children. Hence a trial of patching therapy is recommended for all children with involvement of the macula by retinoblastoma.
评估单眼黄斑区视网膜母细胞瘤患儿的遮盖治疗效果。
15名单眼黄斑区视网膜母细胞瘤患儿接受了弱视遮盖治疗指导。收集的数据包括肿瘤诊断时的年龄、单侧或双侧病变情况、消退肿瘤瘢痕累及后极部的面积及其与中央凹的关系；遮盖治疗的起始时间、持续时间和依从性。记录的视力以logMAR（最小分辨角对数）等效值表示。
12名儿童（80%）为双眼视网膜母细胞瘤，其中一只眼的黄斑区受累，3名儿童为单眼黄斑区肿瘤。开始遮盖治疗的中位年龄为15个月（范围4 - 36个月）。80%的儿童遮盖治疗依从性良好，每天中位遮盖时间为4小时（范围0.5 - 8小时），每周7天，完全遮盖较好眼。后极部受累的中位百分比为34%（范围11% - 100%）。80%的儿童视力有一定改善，在记录最终logMAR视力的儿童中，73%的儿童视力达到1.0 logMAR或更好，53%的儿童视力达到0.5 logMAR或更好。没有证据表明患者年龄、性别、遮盖持续时间或后极部受累百分比与视力改善之间存在关联。
尽管视网膜母细胞瘤累及黄斑区，但80%的儿童仍实现了一定程度的视力恢复。因此，建议对所有视网膜母细胞瘤累及黄斑区的儿童进行遮盖治疗试验。
