Chigane Douglas, Pandya Drishti, Singh Muskaan, Brown Brianne, Lin Michelle, Xu Liya, Stacey Andrew W, Bonnell Alyssa C, Hubbard G Baker, Grossniklaus Hans, Skalet Alison H, Bellsmith Kellyn N, Lally Sara E, Simão-Rafael Margarida, Muñoz Cristina Jou, Català-Mora Jaume, Malaise Denis, Lumbroso-Le Rouic Livia, Matet Alexandre, Chantada Guillermo L, Cassoux Nathalie, Shields Carol L, Berry Jesse L
Division of Ophthalmology, Children's Hospital Los Angeles, Los Angeles, California.
USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
Ophthalmology. 2025 Mar 19. doi: 10.1016/j.ophtha.2025.03.018.
To evaluate the safety profile of aqueous humor (AH) liquid biopsy in pediatric patients with retinoblastoma and retinoblastoma-simulating lesions through a multicenter analysis of paracentesis procedures.
Retrospective multicenter study.
A total of 1203 paracentesis procedures were performed on 484 eyes of 425 pediatric patients, including 352 patients with retinoblastoma and 73 patients with retinoblastoma-simulating lesions.
Medical records were reviewed retrospectively to identify complications from anterior chamber paracentesis performed to obtain AH for liquid biopsy. Procedures were conducted during routine examination under anesthesia. Aqueous humor samples were extracted using a 32-gauge needle and underwent cell-free DNA analysis. Complications were classified as mild, moderate, or severe based on clinical impact and required interventions.
Incidence and severity of complications related to the paracentesis procedure.
Among 1203 procedures, 1 mild complication was identified, representing an overall complication rate of 0.08%. No moderate or severe complications, including vision, eye loss, extraocular tumor spread, or death, were observed at a median follow-up of 16 months. The procedure demonstrated an excellent safety profile across multiple centers, with no permanent adverse outcomes.
Aqueous humor liquid biopsy via anterior chamber paracentesis is a safe and well-tolerated procedure in pediatric patients with retinoblastoma when performed by trained ocular surgeons under general anesthesia. This large-scale analysis supports the procedure's use as a minimally invasive diagnostic tool with minimal risk, providing valuable molecular insights for retinoblastoma management. These findings offer reassurance to clinicians and parents regarding the safety of AH liquid biopsy for retinoblastoma.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
通过对前房穿刺术进行多中心分析，评估视网膜母细胞瘤及视网膜母细胞瘤样病变患儿房水液体活检的安全性。
回顾性多中心研究。
对425例儿科患者的484只眼进行了共1203次前房穿刺术，其中包括352例视网膜母细胞瘤患者和73例视网膜母细胞瘤样病变患者。
回顾性查阅病历，以确定为进行液体活检获取房水而实施的前房穿刺术的并发症。手术在麻醉下的常规检查期间进行。使用32号针头提取房水样本并进行游离DNA分析。根据临床影响和所需干预措施，将并发症分为轻度、中度或重度。
与前房穿刺术相关的并发症的发生率和严重程度。
在1203次手术中，发现1例轻度并发症，总并发症发生率为0.08%。在中位随访16个月时，未观察到中度或重度并发症，包括视力问题、眼球丧失、眼外肿瘤扩散或死亡。该手术在多个中心均显示出良好的安全性，无永久性不良后果。
对于视网膜母细胞瘤患儿，由训练有素的眼科外科医生在全身麻醉下通过前房穿刺术进行房水液体活检是一种安全且耐受性良好的手术。这项大规模分析支持将该手术用作风险最小的微创诊断工具，为视网膜母细胞瘤的管理提供有价值的分子见解。这些发现让临床医生和家长对视网膜母细胞瘤房水液体活检的安全性放心。
在本文末尾的脚注和披露中可能会发现专有或商业披露信息。
