Berry Jesse L, Lee Ramon, Patel Luv, Le Bao Han A, O'Fee John, Jubran Rima, Kim Jonathan W
USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
The Vision Center at Children's Hospital Los Angeles, Los Angeles, California, USA.
Ocul Oncol Pathol. 2019 Jun;5(4):238-244. doi: 10.1159/000493687. Epub 2018 Nov 2.
BACKGROUND/AIMS: The presence of a posterior vitreous detachment (PVD) may play a role in the development of severe retinal toxicity following intravitreal melphalan (IVM) injection for vitreous seeding. We aimed to evaluate the incidence of PVD in retinoblastoma eyes and its association with retinal toxicity after IVM.
We reviewed 112 eyes of 81 retinoblastoma patients with B-scan images available for review from 2010 to 2017. A cohort with vitreous seeding treated with IVM was compared to a cohort that did not undergo injection. The primary outcome measure was the presence of PVD at diagnosis and after treatment. Secondary measures included IVM-associated retinal toxicity and other ocular complications.
The incidence of PVD was 20% at diagnosis, and in eyes with B-scans available both at diagnosis and after treatment 18% of eyes developed a PVD over the course of therapy, more frequently after IVM ( = 0.05). Of 34 eyes receiving IVM treatment, the incidences of posterior segment toxicity and globe salvage were similar between eyes with and without PVD ( = 0.4015 and 0.52, respectively).
In this cohort of patients, there did not appear to be an association with the presence of PVD during IVM and the development of retinal toxicity.
背景/目的：玻璃体后脱离（PVD）的存在可能在玻璃体内注射美法仑（IVM）治疗玻璃体种植后严重视网膜毒性的发生中起作用。我们旨在评估视网膜母细胞瘤患者眼中PVD的发生率及其与IVM后视网膜毒性的相关性。
我们回顾了2010年至2017年81例视网膜母细胞瘤患者的112只眼睛，这些眼睛有可供复查的B超图像。将接受IVM治疗玻璃体种植的队列与未接受注射的队列进行比较。主要观察指标是诊断时和治疗后PVD的存在情况。次要指标包括IVM相关的视网膜毒性和其他眼部并发症。
诊断时PVD的发生率为20%，在诊断时和治疗后均有B超图像的眼睛中，18%的眼睛在治疗过程中出现了PVD，IVM后更常见（P = 0.05）。在接受IVM治疗的34只眼睛中，有PVD和无PVD的眼睛后段毒性和眼球挽救率相似（分别为P = 0.4015和0.52）。
在该队列患者中，IVM期间PVD的存在与视网膜毒性的发生之间似乎没有关联。
