Patterns of subretinal fluid resolution in Group D eyes treated with chemoreduction: Experience from the Children’s Hospital Los Angeles/University of Southern California

Berry, Jesse L.; Shih, Grace; Moysidis, Stavros N.; Jubran, Rima; Wong, Kenneth; Lee, Thomas C; Murphree, A. Linn; Kim, Jonathan W.

doi:10.3109/13816810.2015.1115881

Cited by 5 publications

(7 citation statements)

References 20 publications

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“…The number of patient in each group is given on the top of the graphic. complete resolution is achieved, regardless of the first line therapy administered (Berry et al, 2016b;Rowlands et al, 2018;Shields et al, 1997Shields et al, , 2012. Rhegmatogenous retinal detachments, however, can appear as a treatment-related complication and require appropriate management to allow further tumor control and/or eye preservation.…”

Section: Rhegmatogenous Retinal Detachmentmentioning

confidence: 99%

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Munier

Beck‐Popovic

Chantada

et al. 2019

Progress in Retinal and Eye Research

149

157

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Retinoblastoma is lethal by metastasis if left untreated, so the primary goal of therapy is to preserve life, with ocular survival, visual preservation and quality of life as secondary aims. Historically, enucleation was the first successful therapeutic approach to decrease mortality, followed over 100 years ago by the first eye salvage attempts with radiotherapy. This led to the empiric delineation of a window for conservative management subject to a "state of metastatic grace" never to be violated. Over the last two decades, conservative management of retinoblastoma witnessed an impressive acceleration of improvements, culminating in two major paradigm shifts in therapeutic strategy. Firstly, the introduction of systemic chemotherapy and focal treatments in the late 1990s enabled radiotherapy to be progressively abandoned. Around 10 years later, the advent of chemotherapy in situ, with the capitalization of new routes of targeted drug delivery, namely intra-arterial, intravitreal and now intracameral injections, allowed significant increase in eye preservation rate, definitive eradication of radiotherapy and reduction of systemic chemotherapy. Here we intend to review the relevant knowledge susceptible to improve the conservative management of retinoblastoma in compliance with the "state of metastatic grace", with particular attention to (i) reviewing how new imaging modalities impact the frontiers of conservative management, (ii) dissecting retinoblastoma genesis, growth patterns, and intraocular routes of tumor propagation, (iii) assessing major therapeutic changes and trends, (iv) proposing a classification of relapsing retinoblastoma, (v) examining treatable/preventable disease-related or treatment-induced complications, and (vi) appraising new therapeutic targets and concepts, as well as liquid biopsy potentiality.

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Section: Rhegmatogenous Retinal Detachmentmentioning

confidence: 99%

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Munier

Beck‐Popovic

Chantada

et al. 2019

Progress in Retinal and Eye Research

149

157

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“…A retrospective review from our center showed that 80% of Group D eyes demonstrate subretinal fluid at diagnosis [14], and in this review, similarly, 68% of eyes (Group D and E) demonstrated obscuration of the optic nerve at initial presentation. Of these, 30 (43%) underwent salvage therapy and 39 (57%) primary enucleation.…”

Section: Discussionmentioning

confidence: 99%

Optic Nerve Obscuration in Retinoblastoma: A Risk Factor for Optic Nerve Invasion

et al. 2017

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Background: The objective of this study is to evaluate the risk of optic nerve invasion associated with optic nerve obscuration at diagnosis or persisting during treatment. Methods: Retrospective review from 2011-2016 of patients with advanced retinoblastoma (Group D/E) with complete obscuration of the nerve at diagnosis and a second group of patients with persistent, complete obscuration throughout treatment. Results: Advanced retinoblastoma was diagnosed in 102 eyes of 86 patients. The optic nerve was obscured in 69 eyes (68%) at diagnosis. Of these, 30 (43%) underwent salvage therapy and 39 (57%) primary enucleation. Histopathologic analysis of primarily enucleated eyes showed 41% prelaminar and 15% postlaminar invasion. Four eyes in the salvage group demonstrated persistent nerve obscuration; 2 were subsequently enucleated without evidence of nerve invasion. Average follow-up was 23.5 months (range 1-62 months). Conclusions and Relevance: Optic nerve obscuration at diagnosis may be associated with postlaminar optic nerve invasion. While persistent, complete obscuration of the optic nerve by retinoblastoma during treatment is a poor prognostic sign for both globe salvage and vision, it does not appear, in this small cohort, to increase the risk of optic nerve invasion. With appropriate control of the intraocular tumor, these eyes can be salvaged.

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“…19 However, their series included both partial and total RD, while our series included only total RD cases. 19 In our series, 9 eyes (18%) displayed persistent partial (6%) or total (12%) RD after chemotherapy. All eyes (n = 6) with persistent total RD eventually underwent enucleation for persistent active tumor whereas all three eyes with partial resolution of RD were salvaged.…”

Section: Discussionmentioning

confidence: 96%

“…19 Based on their experience, they suggested that the persistence of RD during chemoreduction is not a negative prognostic indicator of globe salvage. 19 However, their series included both partial and total RD, while our series included only total RD cases. 19 In our series, 9 eyes (18%) displayed persistent partial (6%) or total (12%) RD after chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Retinoblastoma Associated With Total Exudative Retinal Detachment

Ghose

Agarwal

Palkonda

et al. 2023

Retina

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To study the clinical presentation, treatment, and outcomes of eyes presenting with retinoblastoma and total retinal detachment.Methods: A retrospective study of 50 eyes in 43 patients. Results: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.Conclusion: Relatively high tumor recurrence rate is noted in retinoblastoma presenting with total retinal detachment. With appropriate treatment, 70% of the globes can be salvaged.

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Patterns of subretinal fluid resolution in Group D eyes treated with chemoreduction: Experience from the Children’s Hospital Los Angeles/University of Southern California

Cited by 5 publications

References 20 publications

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Optic Nerve Obscuration in Retinoblastoma: A Risk Factor for Optic Nerve Invasion

Retinoblastoma Associated With Total Exudative Retinal Detachment

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