Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma.

Autor: Ventura CV; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Avenue, Suite 262, Miami, FL 33136 USA., Berrocal AM; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Avenue, Suite 262, Miami, FL 33136 USA., Thomson J; Murray Ocular Oncology and Retina, Miami, FL USA., Ehlies FJ; Murray Ocular Oncology and Retina, Miami, FL USA., Latiff A; Murray Ocular Oncology and Retina, Miami, FL USA., Murray TG; Murray Ocular Oncology and Retina, Miami, FL USA.
Jazyk: angličtina
Zdroj: International journal of retina and vitreous [Int J Retina Vitreous] 2017 Aug 14; Vol. 3, pp. 30. Date of Electronic Publication: 2017 Aug 14 (Print Publication: 2017).
DOI: 10.1186/s40942-017-0083-x
Abstrakt: Background: Retinoblastoma is considered the most common intraocular malignancy in childhood, comprising 4% of all pediatric cancers. Management of retinoblastoma has evolved over the past two decades and intra-ophthalmic artery chemotherapy has emerged as a new modality of globe-conserving treatment with excellent results. This treatment achieves effective tumor reduction by delivering localized chemotherapy, decreases enucleation rate, and minimizes systemic and local side effects.
Case Presentation: We report the case of an 8-year-old girl with a late presentation of an advanced unilateral retinoblastoma associated to diffuse exudative retinal detachment in the right eye, classified as group E by the International Classification of Retinoblastoma. The initial therapeutic proposal for the patient was five sessions of intra-ophthalmic artery chemotherapy (IAC) associated to large spot diode laser therapy. After undergoing four sessions of IAC, the fundus exam revealed a giant retinal tear associated to a total retinal detachment in the affected eye. The IAC treatment was concluded and enucleation was considered the best treatment option at that moment, since IAC was unable to control the tumor's activity and the patient's eye presented with a complex rhegmatogenous retinal detachment (RRD). However, family left for a second opinion and never returned.
Conclusions: The usage of IAC for retinoblastoma management may lead to important local complications. Despite rare, RRD secondary to IAC may occur. We postulate that the giant tear observed in this case was caused by the rapid tumor necrosis using this route of treatment.
Databáze: MEDLINE
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