Hwang Cindy S, Mendoza Pia R, Wells Jill R, Grossniklaus Hans E, Hubbard G Baker
Emory Eye Center, 1365 Clifton Rd NE, Atlanta, GA 30324.
Ophthalmol Retina. 2017 Mar-Apr;1(2):165-172. doi: 10.1016/j.oret.2016.09.009.
To evaluate the clinical and histopathologic characteristics of patients who develop proliferative vitreoretinopathy after retinoblastoma treatment.
Retrospective review of three cases of proliferative vitreoretinopathy (PVR) that developed after successful treatment of retinoblastoma from 2003 to 2015.
Three patients with treated retinoblastoma who developed severe PVR and required enucleation.
Review of clinical charts, fundus drawings, Ret-Cam 3 images, and histopathology specimens.
Clinical and histopathologic characterization of PVR in treated retinoblastoma.
Three patients developed severe PVR after sequential thermal laser combined with systemic chemotherapy for retinoblastoma. At presentation patients were 6, 7, and 9 months of age, and all had bilateral retinoblastoma. Time to development of proliferative tissue was 9, 12, and 20 months after initial treatment. Proliferation was characterized by progressive growth of white vascularized tissue with associated traction on the retina and sometimes hemorrhage. All patients underwent enucleation. Histopathologic evaluation revealed treated retinoblastoma tumor with a Type 3 regression pattern, pre- and subretinal fibrovascular tissue consistent with PVR, and reactive changes in the retinal pigment epithelium. None of the patients developed recurrence of retinoblastoma or systemic metastasis.
PVR uncommonly develops after successful treatment of retinoblastoma and may result in traction or rhegmatogenous retinal detachment along with vitreous hemorrhage. Early stages of proliferation may be difficult to distinguish from recurrent tumor. Enucleation may be required due to poor vision and inability to adequately monitor for tumor recurrence.
评估视网膜母细胞瘤治疗后发生增殖性玻璃体视网膜病变（PVR）患者的临床和组织病理学特征。
对2003年至2015年间成功治疗视网膜母细胞瘤后发生的3例增殖性玻璃体视网膜病变（PVR）进行回顾性研究。
3例接受过视网膜母细胞瘤治疗且发生严重PVR并需要眼球摘除术的患者。
回顾临床病历、眼底图、Ret-Cam 3图像和组织病理学标本。
视网膜母细胞瘤治疗后PVR的临床和组织病理学特征。
3例患者在接受视网膜母细胞瘤序贯热激光联合全身化疗后发生严重PVR。就诊时患者年龄分别为6、7和9个月，均为双侧视网膜母细胞瘤。增殖组织出现的时间为初始治疗后9、12和20个月。增殖的特征是白色血管化组织逐渐生长，并伴有对视网膜的牵拉，有时还伴有出血。所有患者均接受了眼球摘除术。组织病理学评估显示，视网膜母细胞瘤肿瘤呈3型消退模式，视网膜前和视网膜下纤维血管组织符合PVR，视网膜色素上皮有反应性改变。所有患者均未发生视网膜母细胞瘤复发或全身转移。
视网膜母细胞瘤成功治疗后很少发生PVR，可能导致牵拉性或孔源性视网膜脱离以及玻璃体积血。增殖早期可能难以与复发性肿瘤区分开来。由于视力差且无法充分监测肿瘤复发，可能需要进行眼球摘除术。
