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RHEGMATOGENOUS RETINAL DETACHMENT AFTER INTRAARTERIAL CHEMOTHERAPY FOR RETINOBLASTOMA: The 2016 Founders Award
Carol L Shields1, Emil A T Say, Maria Pefkianaki
1*Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania; †The Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania; ‡The Nemours Center for Cancer and Blood Disorders, Nemours/Alfred I. DuPont Hospital for Children, Thomas Jefferson University, Wilmington, Delaware; and Departments of §Neurovascular and Endovascular Surgery, and ¶Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
Rhegmatogenous retinal detachment (RRD) occurred in 6% of retinoblastoma eyes treated with intraarterial chemotherapy (IAC). This complication was primarily linked to tumor regression causing retinal holes, especially in advanced cases.
Area of Science:
- Ophthalmology
- Oncology
- Retinal Diseases
Background:
- Intraarterial chemotherapy (IAC) is a key treatment for retinoblastoma.
- Evaluating complications like rhegmatogenous retinal detachment (RRD) after IAC is crucial for patient outcomes.
Discussion:
- This study retrospectively analyzed 167 eyes of 157 patients treated with IAC for retinoblastoma.
- Rhegmatogenous retinal detachment (RRD) developed in 6% of eyes, predominantly associated with rapid tumor regression leading to atrophic retinal holes.
Key Insights:
- RRD after IAC was more frequent in advanced retinoblastoma (Group E) and eyes with endophytic tumors.
- Factors associated with RRD included older age at presentation and increased vitreous seeding.
- The primary cause of RRD was tumor regression-induced retinal holes, not intravitreal injections.
Outlook:
- Further research may explore strategies to mitigate RRD risk in high-risk retinoblastoma patients undergoing IAC.
- Long-term monitoring is essential for eyes treated with IAC, given the potential for delayed complications.
- Understanding RRD development can inform treatment adjustments and improve visual salvage rates in retinoblastoma.
