Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
Retina. 2019 Dec;39(12):2264-2272. doi: 10.1097/IAE.0000000000002315.
To determine whether treatment order affects ophthalmic vascular event rates after intra-arterial chemotherapy (IAC) for retinoblastoma.
Patients who received IAC as primary or secondary treatment for retinoblastoma from January 2009 to January 2018 were included. All eyes were imaged with fundus photography and fluorescein angiography. Patient characteristics and vascular event rates were compared using t-test and Fisher's exact test.
There were 196 patients treated with 682 infusions of IAC, divided into primary (no previous therapy, 98 eyes of 98 patients, 328 infusions) and secondary (after other therapy, 105 eyes of 98 patients, 354 infusions) treatment. Overall, ophthalmic vascular events were found after 5% of infusions (17% eyes). A comparison of ophthalmic vascular events (primary vs. secondary IAC), with mean three infusions per eye (median 3, range 1-7), revealed no difference in overall percentage of eyes affected (18% vs. 15%, P = 0.57). Adverse vascular events per eye included retinal vasculature attenuation (1% vs. 0%, P = 0.99), peripheral retinal pruning (1% vs. 0%, P = 0.99), branch retinal artery occlusion (0% vs. 1%, P = 0.99), central retinal artery occlusion (0% vs. 1%, P = 0.99), macular ischemia (0% vs. 2%, P = 0.51), vitreous hemorrhage (2% vs. 3%, P = 0.92), subretinal hemorrhage (1% vs. 0%, P = 0.99), retinal pigment epithelium atrophy (6% vs. 3% P = 0.43), choroidal atrophy (4% vs. 2%, P = 0.92), optic disk pallor (1% vs. 0%, P = 0.99), and ophthalmic artery occlusion (9% vs. 6%, P = 0.35).
Ophthalmic vascular events after IAC for retinoblastoma affect only 5% of eyes per infusion (17% of treated eyes). Vascular event risk per eye is similar when using IAC as primary or secondary treatment.
确定视网膜母细胞瘤经动脉内化疗（IAC）治疗后，治疗顺序是否会影响眼部血管事件的发生率。
纳入 2009 年 1 月至 2018 年 1 月期间接受 IAC 作为原发性或继发性治疗的视网膜母细胞瘤患者。所有患者均接受眼底照相和荧光素血管造影检查。采用 t 检验和 Fisher 确切概率法比较患者特征和血管事件发生率。
共有 196 名患者接受了 682 次 IAC 治疗，分为原发性（无既往治疗，98 只眼，98 例患者，328 次）和继发性（其他治疗后，105 只眼，98 例患者，354 次）。总体而言，5%的输注后出现眼部血管事件（17%的眼）。比较眼部血管事件（原发性 vs. 继发性 IAC），每只眼平均输注 3 次（中位数 3，范围 1-7），发现受影响眼的总体百分比无差异（18% vs. 15%，P=0.57）。每只眼的不良血管事件包括视网膜血管衰减（1% vs. 0%，P=0.99）、周边视网膜修剪（1% vs. 0%，P=0.99）、视网膜分支动脉阻塞（0% vs. 1%，P=0.99）、视网膜中央动脉阻塞（0% vs. 1%，P=0.99）、黄斑缺血（0% vs. 2%，P=0.51）、玻璃体积血（2% vs. 3%，P=0.92）、视网膜下出血（1% vs. 0%，P=0.99）、视网膜色素上皮萎缩（6% vs. 3%，P=0.43）、脉络膜萎缩（4% vs. 2%，P=0.92）、视盘苍白（1% vs. 0%，P=0.99）和眼动脉阻塞（9% vs. 6%，P=0.35）。
视网膜母细胞瘤经 IAC 治疗后的眼部血管事件仅影响每输注 5%的眼（17%的治疗眼）。当 IAC 作为原发性或继发性治疗时，每只眼的血管事件风险相似。
