Department of Pediatric Ophthalmology and Strabismus and Adult Motilty, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Ophthalmic Genet. 2023 Aug;44(4):385-388. doi: 10.1080/13816810.2022.2116652. Epub 2022 Nov 4.
To describe a patient with retinoblastoma and subsequent maculopathy unrelated to the tumor but related to intra-arterial melphalan documented by pattern electroretinography.
Comprehensive ophthalmic evaluation, treatment with intra-arterial chemotherapy and subsequent follow-up including electroretinography to assess for macular dysfunction.
A 3-year-old child was evaluated with electrophysiological investigations following treatment of unilateral Group D retinoblastoma with intra-arterial and intravitreal chemotherapy with melphalan. Pattern reversal visual evoked potential amplitude and P100 latency were normal in the left eye, but abnormal and delayed in the right eye. Pattern electroretinograms (pERGs) were abnormal on the right eye. Flash electroretinograms (fERGs) were normal on both eyes. Visual acuity dysfunction of 20/50 attributed to melphalan was seen on the right eye vs 20/40 on the left eye.
Our case report demonstrates that pERG rather than fERG should be used to monitor baseline macular function and potential toxicity in children undergoing chemotherapy for retinoblastoma using skin electrodes when corneal electrodes are not tolerated.
描述一名患有视网膜母细胞瘤（RB）且与肿瘤无关但与动脉内注射甲氨蝶呤（melphalan）相关的黄斑病变患者，该病变可通过图形视网膜电图（pattern electroretinography）记录。
全面眼科评估、接受动脉内化疗治疗，以及后续进行视网膜电图检查以评估黄斑功能。
一名 3 岁儿童在接受单侧 D 组 RB 治疗后，进行了包括电生理研究在内的综合评估，该治疗采用了动脉内和玻璃体内注射甲氨蝶呤。左眼的图形翻转视觉诱发电位（pattern reversal visual evoked potential）振幅和 P100 潜伏期正常，但右眼异常且延迟。右眼图形视网膜电图（pattern electroretinogram，pERG）异常。双眼闪光视网膜电图（flash electroretinogram，fERG）正常。右眼视力障碍为 20/50，归因于甲氨蝶呤，而左眼为 20/40。
我们的病例报告表明，当角膜电极不能耐受时，在接受化疗治疗 RB 的儿童中，使用皮肤电极进行监测时，pERG 而不是 fERG 应该用于监测基线黄斑功能和潜在毒性。
