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Puncture-Induced Iris Neovascularization as a Mouse Model of Rubeosis Iridis
Published on: March 8, 2018
Resolution of iris neovascularization following chemoreduction of retinoblastoma
Jinali Patel1, Kiran Turaka, Carol L Shields
1Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Insights
Chemotherapy effectively treated advanced retinoblastoma (group E) with iris neovascularization in a young child. This conservative approach led to tumor regression and resolution of neovascularization, preserving the eye.
Area of Science:
- Pediatric Oncology
- Ophthalmology
Background:
- Retinoblastoma is the most common primary intraocular malignancy in children.
- Advanced retinoblastoma, particularly group E, presents significant treatment challenges.
- Iris neovascularization is a concerning sign in advanced retinoblastoma, indicating potential complications like glaucoma.
Observation:
- A 30-month-old girl presented with bilateral retinoblastoma, including advanced group E disease and iris neovascularization in the left eye.
- The patient received six cycles of combination chemotherapy: vincristine, carboplatin, and etoposide.
- Intraocular pressure was monitored and initially measured at 13 mm Hg in the affected eye.
Findings:
- Following chemotherapy, dramatic regression of retinoblastoma was observed in the left eye.
- Complete resolution of iris neovascularization was achieved within one month of treatment.
- The positive response, including neovascularization resolution, remained stable at three months of follow-up.
Implications:
- Systemic chemotherapy offers an effective conservative treatment strategy for advanced retinoblastoma.
- This approach can successfully salvage eyes with iris neovascularization, potentially preventing glaucoma development.
- Early and effective chemotherapy may improve ocular salvage rates in high-risk retinoblastoma cases.
Abstract:
The authors report a case of advanced retinoblastoma (group E) with iris neovascularization. A 30-month-old girl was diagnosed as having group B retinoblastoma in the right eye and group E retinoblastoma and iris neovascularization with an intraocular pressure of 13 mm Hg in the left eye. The tumors were treated with six cycles of chemotherapy using vincristine (0.9 mg/m(2)), carboplatin (336 mg/m(2)), and etoposide (90 mg/m(2)). At 1 month of follow-up, there was dramatic regression of the retinoblastoma in the left eye and complete resolution of the iris neovascularization, which remained stable at 3 months of follow-up. Chemotherapy is an effective conservative treatment for advanced retinoblastoma and can successfully salvage eyes with neovascularization, particularly before the onset of glaucoma.