OUTCOMES OF CRYOTHERAPY FOR THE TREATMENT OF RETINOBLASTOMA IN 92 CONSECUTIVE PATIENTS

To report the incidence, risk factors, clinical course, and visual outcomes of rhegmatogenous retinal detachment (RRD) and vitreous haemorrhage (VH) following cryotherapy for retinoblastoma.

A single-centre retrospective review of patients treated with cryotherapy for retinoblastoma between January 2013 and December 2022.

Of 124 eyes in 92 patients treated with cryotherapy, RRD developed in 7 (6%) and VH in 9 (7%) eyes. RRD persisted in 1 eye (<1%) and VH in 5 eyes (4%), while RRD and VH resolved spontaneously in remaining eyes. Increased cryotherapy applications were associated with VH risk (p<0.01) but not with RRD. Cryotherapy recipients who had also received intra-arterial chemotherapy (n=50) were associated with VH risk (p=0.01). Management for persistent complications were referral for scleral buckling (1 RRD), observation (1 VH), or enucleation (4 VH: 3 tumour progression, 1 no retinal view). Cryotherapy-induced visual loss occurred in one RRD (<1%, baseline vs final visual acuity: 20/20 vs 20/40), and in one VH (<1%, enucleation due to no view). Baseline vision was preserved in the majority of globe-salvaged cases.

Complications post-cryotherapy in retinoblastoma management are rare. Increased cryotherapy applications may increase the risk of VH, but cryotherapy-related visual loss was rare.