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。