Piña Yolanda, Boutrid Hinda, Murray Timothy G, Wolfe Stacey Quintero, Schefler Amy C, Houston Samuel K, Moftakhar Roham, Fernandes Cristina E, Reichbach Jennifer, Aziz Hassan A, Markoe Arnold M, Aziz-Sultan Mohammad Ali
Bascom Palmer Eye Institute, Miami, Florida, USA.
J Pediatr Ophthalmol Strabismus. 2010 Sep 22;47 Online:e1-5. doi: 10.3928/01913913-20100920-04.
The purpose of this study was to report significant alterations in orbital vasculature following combined systemic chemoreduction/laser ablation and periocular carboplatin treatment and to discuss treatment implications in two cases of advanced retinoblastoma. Assessment of orbital and ophthalmic vasculature was done following nine cycles of systemic chemotherapy. Intra-arterial chemotherapy was provided 6 months following completion of systemic chemoreduction, when the tumor was clearly active and progressive. Orbital angiography of both eyes, performed prior to the intra-arterial melphalan injection, documented sclerosis of the ophthalmic artery vasculature with delayed transit time, decreased choroidal blush, and anomalous vessels in the eye receiving periocular carboplatin injections. The orbital vasculature in the contralateral eye was not affected. Orbital and ophthalmic vascular alterations may occur with the use of combined systemic chemotherapy and periocular carboplatin. Systemic chemotherapy and focal transpupillary laser tumor ablation, alone, did not appear to impact the orbital and ophthalmic vascular supply. Impaired vascular supply may have significant influence on the impact of the efficacy of standard and future experimental therapeutic options.
本研究的目的是报告全身化学减容/激光消融联合眼周卡铂治疗后眼眶血管系统的显著变化，并讨论两例晚期视网膜母细胞瘤的治疗意义。在进行九个周期的全身化疗后，对眼眶和眼部血管系统进行评估。在全身化学减容完成6个月后，当肿瘤明显活跃且进展时，进行动脉内化疗。在动脉内注射美法仑之前，对双眼进行眼眶血管造影，结果显示眼动脉血管系统硬化，转运时间延迟，脉络膜充血减少，接受眼周卡铂注射的眼睛出现异常血管。对侧眼的眼眶血管系统未受影响。联合使用全身化疗和眼周卡铂可能会导致眼眶和眼部血管改变。单独使用全身化疗和局部经瞳孔激光肿瘤消融似乎不会影响眼眶和眼部血管供应。血管供应受损可能会对标准治疗和未来实验性治疗方案的疗效产生重大影响。
