Korean J Ophthalmol.  2010 Dec;24(6):347-352. 10.3341/kjo.2010.24.6.347.

Visual Prognosis of Retinoblastoma in the Posterior Pole Treated with Primary Chemotherapy Plus Local Treatments

• Kim JM
• Kim JH
• Kim SJ
• Park KD
• Shin HY
• Ahn HS
• Yu YS

• KMID: 1769088
• DOI: http://doi.org/10.3341/kjo.2010.24.6.347

Abstract

PURPOSE
To evaluate the visual outcomes of retinoblastoma in the posterior pole (RBPP) treated with chemotherapy plus local treatments and to address the prognostic factors that influence such outcomes.
METHODS
The medical records of patients with RBPP diagnosed at the Department of Pediatric Ophthalmology, Seoul National University Children's Hospital between August 1987 and September 2007 were reviewed retrospectively. Only those patients treated via primary chemotherapy plus local treatments were included. The presence of foveal involvement and tumors in the posterior pole before and after treatment, the type of regression pattern and the best corrected visual acuity (BCVA) of each patient were evaluated.
RESULTS
A total of 13 eyes in 12 patients were included. The mean final BCVA for treated RBPP was 20/210 (range, hand motion to 20/16). However, eight eyes (61.5%) had an acuity of 20/200 or better and seven eyes (53.8%) had an acuity of 20/50 or better. The mean final BCVA was significantly better in cases with negative foveal involvement; however, four eyes (37.5%) with positive foveal involvement had an acuity of 20/200 or better. Tumors area in the posterior pole and the type of regression pattern were not significantly related to final BCVA.
CONCLUSIONS
Over one half of the studied RBPP patients had working vision. Although the eyes had RBPP with positive foveal involvement, about one-third of the patients had working vision. Vision preservation should be considered when deciding on RBPP treatment.

Keyword

Fovea; Macula; Posterior pole; Prognosis; Retinoblastoma

MeSH Terms

Antibiotics, Antineoplastic/administration & dosage
Antineoplastic Agents/administration & dosage
Antineoplastic Agents, Alkylating/administration & dosage
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Cisplatin/administration & dosage
Cyclophosphamide/administration & dosage
Doxorubicin/administration & dosage
Etoposide/administration & dosage
Eyeglasses
Female
Follow-Up Studies
Fovea Centralis/pathology
Humans
Infant
Male
Prognosis
Retinal Neoplasms/*drug therapy/pathology/*physiopathology
Retinoblastoma/*drug therapy/pathology/*physiopathology
Retrospective Studies
Treatment Outcome
Visual Acuity