Desjardins Laurence, Chefchaouni Mohamed Charif, Lumbroso Livia, Levy Christine, Asselain Bernard, Bours Daniele, Vedrenne Jacques, Zucker Jean-Michel, Doz François
Department of Ocular Oncology, Institut Curie, Paris, France.
J AAPOS. 2002 Apr;6(2):108-11. doi: 10.1067/mpa.2002.121451.
Because of the long-term complications associated with external beam radiation in retinoblastoma, alternative treatment methods have been investigated. We conducted a retrospective study to evaluate the functional results of new treatment modalities.
Thirty-seven eyes were treated without external beam irradiation in 31 patients. The median diameter of the largest tumor in each eye was 6 mm. Primary chemotherapy was used in 25 cases, chemothermotherapy was used in 32 cases, cryotherapy was used in 28 cases, iodine 125 Plaques were used in 15 cases, diode laser thermotherapy was used alone in 11 cases, and photocoagulation was performed in 5 cases. The median follow-up after diagnosis of retinoblastoma was 41 months. The visual results were evaluated at a median age of 54 months.
The median visual acuity of the treated eyes was 20/33. Twenty-four eyes presented a visual acuity better than 20/40, 4 eyes had a visual acuity between 20/200 and 20/40, and 9 eyes had a visual acuity less than 20/200. Maculopathy was observed in 16 cases, associated with papillopathy in 1 case. A cataract was observed in 1 case and a vitreous hemorrhage was observed in another case. Twenty-one eyes did not develop any complications. No corneal dryness and very few lens changes were observed.
The functional results after local treatments for retinoblastoma are very good. The most frequent complication is maculopathy, particularly when the tumor involves or is situated close to the macula.
由于视网膜母细胞瘤外照射放疗存在长期并发症，人们对其他治疗方法进行了研究。我们进行了一项回顾性研究，以评估新治疗方式的功能结果。
31例患者的37只眼未接受外照射放疗。每只眼中最大肿瘤的中位直径为6毫米。25例采用了初始化疗，32例采用了化疗热疗，28例采用了冷冻疗法，15例采用了碘125敷贴，11例单独采用了二极管激光热疗，5例进行了光凝治疗。视网膜母细胞瘤诊断后的中位随访时间为41个月。在中位年龄54个月时评估视力结果。
治疗眼的中位视力为20/33。24只眼的视力优于20/40，4只眼的视力在20/200至20/40之间，9只眼的视力低于20/200。16例观察到黄斑病变，其中1例伴有视乳头病变。1例观察到白内障，另1例观察到玻璃体出血。21只眼未出现任何并发症。未观察到角膜干燥，晶状体变化也很少。
视网膜母细胞瘤局部治疗后的功能结果非常好。最常见的并发症是黄斑病变，尤其是当肿瘤累及或位于黄斑附近时。
