El Hamichi Sophia, Acon Dhariana, Kon Graversen Veronica, Gold Aaron S, Berrocal Audina M, Murray Timothy G
Miami Ocular Oncology and Retina, Miami, FL, USA.
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
J Ophthalmol. 2020 Sep 10;2020:1486757. doi: 10.1155/2020/1486757. eCollection 2020.
Retinoblastoma (RB) is the most common eye tumor in children. There have been significant improvements in treatment options targeting killing the tumor while also conserving the eye and attempting to conserve functional vision. Retinal detachment (RD) is not an uncommon event and compromises the vision and sometimes RB treatment.
Retrospective review of 62 patients over a period of 8 years between 2012 and 2019 with eyes treated for RB and having persistent RD that did not resolve after complete tumor regression.
Forty-two patients of these 62 cases developed RD (67%). The RD resolved in 35 patients (83% of RD), and 7 patients (16% of RD) developed a persistent RD. In all the persistent RD groups (7 patients/11 eyes), RB and RD were present simultaneously in the first ophthalmological assessment. Sex ratio was 2 females/5 males. The mean age of diagnosis was 11 months. All eyes had advanced RB stages. Eight eyes had local treatment with transpupillary laser, 6 eyes received IAC, and 3 patients received systemic chemotherapy. In 9 eyes, the RD had both exudative and tractional components. Only one eye had a pure tractional RD due to persistent fetal vasculature, and one eye had rhegmatogenous RD component with presence of a tear in addition to exudation. None of the eyes received RD surgical repair.
Persistent RD occurs in eyes with advanced RB stages with complex RD with more than one component. The dilemma is performing a vitrectomy in eyes with cancer and poor visual outcome.
视网膜母细胞瘤（RB）是儿童中最常见的眼部肿瘤。在治疗方案方面已经取得了显著进展，目标是在杀死肿瘤的同时保留眼球并试图保留功能性视力。视网膜脱离（RD）并非罕见事件，会损害视力，有时还会影响RB的治疗。
回顾性分析2012年至2019年期间8年内62例接受RB治疗且肿瘤完全消退后仍存在持续性RD的患者。
这62例患者中有42例发生了RD（67%）。35例患者的RD得到缓解（占RD患者的83%），7例患者（占RD患者的16%）出现持续性RD。在所有持续性RD组（7例患者/11只眼）中，首次眼科评估时RB和RD同时存在。性别比为2名女性/5名男性。诊断时的平均年龄为11个月。所有眼睛均处于RB晚期。8只眼接受了经瞳孔激光局部治疗，6只眼接受了眼动脉化疗（IAC），3例患者接受了全身化疗。9只眼中，RD既有渗出性成分又有牵拉性成分。仅1只眼因持续性胎儿血管系统出现单纯牵拉性RD，1只眼除渗出外还存在裂孔源性RD成分及裂孔。所有眼睛均未接受RD手术修复。
持续性RD发生于RB晚期且RD复杂、存在多种成分的眼睛。困境在于对患有癌症且视力预后较差的眼睛进行玻璃体切除术。
