Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India.
Retina. 2023 May 1;43(5):808-814. doi: 10.1097/IAE.0000000000003734.
To study the clinical presentation, treatment, and outcomes of eyes presenting with retinoblastoma and total retinal detachment.
A retrospective study of 50 eyes in 43 patients.
The mean age at presentation was 15 months (median, 9 months). Retinoblastoma-associated total retinal detachment was unilateral (n = 36; 84%) or bilateral (n = 7; 16%). The mean tumor basal diameter was 17 mm (median, 18 mm), and the mean tumor thickness was 13 mm (median, 12 mm). Associated features included subretinal seeds (n = 26; 52%), vitreous seeds (n = 13; 26%), and subretinal exudation (n = 4; 8%). Based on eighth edition of American Joint Committee on Cancer classification, the tumors were classified as cT2a (n = 19; 38%), cT2b (n = 28; 56%), or cT3c (n = 3; 6%). Primary treatment included intravenous (n = 48; 96%) or intraarterial chemotherapy (n = 2; 4%). Over a mean follow-up period of 30 months (median, 29 months; range, 7-62 months), retinal detachment resolved in 41 eyes (82%), tumor recurrence was noted in 39 eyes (78%), globe salvage was achieved in 35 eyes (70%), and one patient (2%) died due to metastasis.
Relatively high tumor recurrence rate is noted in retinoblastoma presenting with total retinal detachment. With appropriate treatment, 70% of the globes can be salvaged.
研究伴有视网膜母细胞瘤和全视网膜脱离的眼的临床表现、治疗和结局。
对 43 例患者的 50 只眼进行回顾性研究。
就诊时的平均年龄为 15 个月（中位数为 9 个月）。视网膜母细胞瘤相关的全视网膜脱离为单侧（n = 36；84%）或双侧（n = 7；16%）。平均肿瘤基底直径为 17mm（中位数为 18mm），平均肿瘤厚度为 13mm（中位数为 12mm）。相关特征包括视网膜下种子（n = 26；52%）、玻璃体种子（n = 13；26%）和视网膜下渗出（n = 4；8%）。根据第八版美国癌症联合委员会分类，肿瘤分为 cT2a（n = 19；38%）、cT2b（n = 28；56%）或 cT3c（n = 3；6%）。主要治疗方法包括静脉内（n = 48；96%）或动脉内化疗（n = 2；4%）。在平均 30 个月（中位数，29 个月；范围，7-62 个月）的随访期间，41 只眼（82%）视网膜脱离得到缓解，39 只眼（78%）出现肿瘤复发，35 只眼（70%）眼球得以保存，1 例患者（2%）因转移而死亡。
伴有全视网膜脱离的视网膜母细胞瘤复发率相对较高。通过适当的治疗，70%的眼球可以保存。
