Ocular and Orbital Complications following the Treatment of Retinoblastoma

Anteby, Irene; Ramu, Nili; Gradstein, Libe; Miskin, Hagit; Pe’er, Jacob; BenEzra, David

doi:10.1177/112067219800800210

Cited by 37 publications

(25 citation statements)

References 20 publications

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“…Radiation retinopathy is caused by an occlusive microangiopathy manifested by microaneuvrysms, retinal hemorrhages, macular edema, and vitreous hemorrhage. In general, radiation retinopathy occurs at doses in excess of 4500 cGy; Anteby et al [17] showed that radiation retinopathy developed in 12% of long-term survivors and was ® rst detected 11± 72 months after treatment.…”

Section: Discussionmentioning

confidence: 98%

Long-Term Follow-Up of Children With Retinoblastoma

Nahum

Gdal-On

Kuten

et al. 2001

Pediatric Hematology and Oncology

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Twenty-one pediatric retinoblastoma (RB) patients treated between 1976 and 1994 were evaluated for late treatment-related complications. Median age at diagnosis was 24 months; median age at follow-up was 12 years; median follow-up time was 12 years. Of the 21 patients, 14 had unilateral RB and 7 had bilateral RB. Thirteen patients had received external radiotherapy and 8 children were treated by chemotherapy. Twenty-one patients had undergone enucleation. Radiation-induced cataracts were found in 3 patients, radiation retinopathy in 1, enucleation and postradiotherapy contracted socket in 1, very low visual acuity postradiotherapy in 3, severe hypotelorism in 2, growth hormone deficiency in 2, neurocognitive disorders in 6, and orbital deformation due to radiation bone atrophy was moderate-severe in 12 patients. Azoospermia was found in 1 patient treated by cyclophosphamide and vincristine. The most frequent sequela in this group of RB-cured children were postradiotherapy orbital deformation due to bone atrophy and neurocognitive disabilities. Late radiation effects must be avoided by using modern, innovative, and more sophisticated radiotherapeutic techniques. Late treatment-related complications justify the long-term follow-up of childhood RB survivors.

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Section: Discussionmentioning

confidence: 98%

Long-Term Follow-Up of Children With Retinoblastoma

Nahum

Gdal-On

Kuten

et al. 2001

Pediatric Hematology and Oncology

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“…This dose is much higher than and almost double that used in patients with retinoblastoma; however, it is a standard dose of postoperative radiation in the head and neck for a variety of histologies, including melanoma and squamous carcinoma. Many articles in the literature discuss the role of external beam radiation therapy in retinoblastoma, 8–14 and the radiation doses described in these articles range from 30 to 55 Gy. Nahum et al reported a case series of 21 pediatric patients with retinoblastoma, 13 of whom had bilateral retinoblastoma and received external beam radiation therapy to a median dose of 32.3 Gy.…”

Section: Discussionmentioning

confidence: 99%

“…In a larger case series of 36 pediatric patients with bilateral retinoblastoma, Anteby et al reported a 3% rate of severe socket contracture at a median follow-up time of 36 months. 14 The significantly lower rates of severe socket contracture in patients with retinoblastoma than in patients with uveal melanoma could be explained by the lower dose of radiation used. It could also be explained by the fact that most retinoblastoma patients who undergo radiation therapy may not have had significant surgery; surgical intervention may have an additive effect to contracture of the socket.…”

Section: Discussionmentioning

confidence: 99%

Management of Radiation-Induced Severe Anophthalmic Socket Contracture in Patients With Uveal Melanoma

Nasser

Gombos

Williams

et al. 2012

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose High-dose radiotherapy can cause contracture of the anophthalmic socket, but the incidence of this complication in patients with enucleation for uveal melanoma has not previously been reported. We reviewed the surgical management and outcomes in terms of successful prosthesis wear in patients with severe contracture of the anophthalmic socket treated with high-dose radiotherapy for high-risk uveal melanoma and estimated the relative risk of this complication. Methods The medical records of all consecutive patients enrolled in a prospective uveal-melanoma tissue-banking protocol at our institution who underwent enucleation between January 2003 and December 2010 were reviewed. Patients who underwent adjuvant radiotherapy of the enucleated socket were further studied. Results Of the 68 patients enrolled in the prospective tissue banking protocol, 12 had high-risk histologic features (e.g., extrascleral spread or vortex vein invasion) and were treated with 60 Gy of external-beam radiotherapy after enucleation. Five of these patients (41.7%) experienced severe socket contracture precluding prosthesis wear. The median time to onset of contracture following completion of radiotherapy was 20 months. Three patients underwent surgery, which entailed scar tissue release, oral mucous membrane grafting, and socket reconstruction; 2 patients declined surgery. All 3 patients who had surgery experienced significant improvement of socket contracture that enabled patients to wear a prosthesis again. Conclusion High-dose radiotherapy after enucleation in patients with uveal melanoma caused severe socket contracture and inability to wear a prosthesis in approximately 40% of patients. Surgical repair of the contracted socket using oral mucous membrane grafting can allow resumption of prosthesis wear.

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“…Most previous investigations of cataracts after EBRT for Rb had relatively small sample sizes, short follow-up periods of less than 15 years, and no information on other potential risk factors resulting in large variability in risk estimates (6, 7, 10–14). This report presents long-term follow-up of one of the largest cohorts of adult Rb survivors to investigate the risk for cataract extraction associated with therapeutic exposure of ionizing radiation to the lens of the eye.…”

Section: Introductionmentioning

confidence: 99%