Study of Management of Retinoblastoma with Vitreous Seeds (Retrospective Study)

Abstract
Background: The response of retinoblastoma with vitreous seeds to the different modalities of treatment as regards tumor regression, vitreous seeds regression and eye salvage.
Aim of the Work: Study of the response of Rb with vitreous seeds to the different modalities of treatment as regards tumor regression, vitreous seeds regression and eye salvage.
Patients and methods: This is a retrospective observational study in which we collected the data from medical records of cases of retinoblastoma with vitreous seeds who were managed over ten years at Ocular Oncology Unit, Ophthalmology Department, Ain Shams University Hospitals in the period from January 2004 to June 2015 and followed-up for at least 12 months after the completion of treatment. Our study included 37 patients. Fourty-two eyes affected with retino-blastoma with vitreous seeds were divided into four groups according to the modality of treatment: Group (1): 15 eyes treated with chemoreduction±focal therapy (diode laser ther-motherapy or cryotherapy), Group (2): 8 eyes treated with intravitreal chemotherapy, Group (3): 2 eyes treated with intra-arterial chemotherapy and Group (4): 17 eyes of treated with subTenon's Carboplatin. All eyes had received systemic chemotherapy as a primary treatment before these modalities of treatment.
Results: Our study showed that the rate of ocular salvage was the highest in group 4 (52.9%) followed by group 1 (40%), group 2 (20%) and group 3 (0.0%). There was a statistically significant difference between group 1 and group 4 as regards tumor number, tumor location, tumor base diam-eter, number of thermotherapy sessions as primary treatment, mean duration of follow-up and event free interval from last treatment.
Conclusion: Subtenon's Carboplatin, chemoreduction plus focal therapy, intravitreal chemotherapy and intra-arterial chemotherapy may be effective supplementary modalities of treatment that help in ocular salvage.