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The development of young children with retinoblastoma
G Ross1, E G Lipper, D Abramson
1Department of Pediatrics, N506, Weill-Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, New York, NY 10021, USA.
Insights
Children with retinoblastoma (RB) generally show normal development, but may experience delays in visuomotor skills. Early intervention can improve outcomes for visually impaired children with RB.
Area of Science:
- Pediatric Oncology
- Developmental Pediatrics
- Ophthalmology
Background:
- Retinoblastoma (RB) is a pediatric eye cancer requiring intensive treatment.
- Assessing long-term health and developmental outcomes in RB survivors is crucial.
- Understanding risk factors for developmental delays in children with RB is essential for targeted support.
Purpose of the Study:
- To evaluate the overall health and development of children with retinoblastoma (RB).
- To determine if children with RB are at higher risk for developmental delays compared to healthy children.
- To investigate the impact of RB type (unilateral vs. bilateral), family history, and treatment intensity on developmental outcomes.
Main Methods:
- A descriptive study involving medical record review and comprehensive pediatric, psychological, and visual assessments.
- Fifty-four children under 41 months with RB were evaluated using standardized tests (Bayley Scales of Infant Development II) and behavioral visual acuity tests.
- Data collected included demographic variables, age at diagnosis, RB type, family history, and treatment details.
Main Results:
- Most children with RB had normal physical growth and health, with average mental and motor development scores within the normal range.
- Twenty-six children (48%) were referred for early intervention, primarily for visuomotor coordination issues (21/26).
- Children with bilateral RB demonstrated significantly poorer motor development and required more diverse treatments compared to those with unilateral RB.
Conclusions:
- Children with retinoblastoma generally exhibit normal physical health and cognitive/motor development.
- A significant proportion of children with RB experience delays in visuomotor integration, necessitating specialized support.
- Early developmental evaluations and interventions can positively impact the visuomotor development of children with RB-related visual impairments.
Objectives:
To assess the health and development of children with retinoblastoma (RB), or cancer of the retina, and to determine if they are at greater risk for developmental delays than normal children. Specific aims were to determine if type of RB (unilateral vs bilateral), family history, and number of treatment types affected mental and motor development.
Design:
Descriptive study based on medical record review and pediatric, psychological, and visual evaluations.
Setting:
Major referral center for patients with RB and early intervention program in a voluntary urban hospital.
Subjects And Methods:
Fifty-four children younger than 41 months with RB who attend an ophthalmology oncology clinic were recruited for study. Measures included demographic variables such as social class and race/ethnicity, and medical factors such as age at diagnosis (<18 months vs >18 months), type of RB (unilateral or bilateral), family history of RB, and number and types of treatments. All children received a pediatric examination that assessed physical growth and health; a behavioral test of visual acuity using Teller acuity cards; and the Bayley Scales of Infant Development II, a standardized test of mental and motor development. Children found to have delays were referred to intervention services to treat their specific areas of weakness.
Results:
Three quarters of the children had had 1 eye enucleated; 51 of 54 had normal vision in at least 1 eye, and the other 3 had partial vision in 1 eye. Except for the RB, 46 children were largely normal in growth and health, and 8 had medical diagnoses that were unrelated to RB or its treatment. The average mental and motor development scores were in the normal range (91.4 +/- 16.3, and 91.1 +/- 13.4) and not significantly lower than the normal population. Twenty-six children were referred for early intervention services, and 21 of 26 were referred for services to improve their visuomotor coordination. Demographic variables were not associated with medical variables or outcome. Children with bilateral RB, in which both eyes are affected, performed significantly less well in motor development, received many more types of treatments, and were more likely to be referred for visuomotor therapy than children with unilateral RB.
Conclusions:
Children with RB generally function normally in terms of physical health and mental and motor development. However, they are more likely to show delays in visuomotor integration. Early developmental evaluations may improve the visuomotor development of children with visual impairment due to RB.