1/41. Rhegmatogenous retinal detachment after treatment of retinoblastoma.PURPOSE: To determine the rate of retinal detachment after treatment of retinoblastoma, to describe the clinical features and management, and to discuss possible pathogenic mechanisms. methods: We retrospectively analyzed the charts of 80 patients (83 eyes) with retinoblastoma treated conservatively between 1963 and 1994, looking specifically for cases that developed a retinal detachment after treatment. RESULTS: Five patients (5 eyes, stages IVa to Vb) developed a retinal detachment after treatment. Of these, four had undergone external radiotherapy and one had an episcleral cobalt plaque. retinal detachment developed within three months after radiotherapy and relentlessly progressed in all four eyes over a period of five months to four years. In the eye that received the episcleral cobalt plaque, the detachment remained localized inferiorly. Even though no retinal break could be detected in four eyes, the clinical features were suggestive of a rhegmatogenous detachment: there was retinal thinning adjacent to the regressed tumors, and the evolution was much longer than that of an exudative retinal detachment. A scleral buckling procedure was performed in two eyes and the retina was successfully reattached. The retinal detachment was not operated on in the three other eyes: the hole was too posterior in one eye; retinal surgery was refused in the second eye; and the retinal detachment remained localized inferiorly in the third eye. CONCLUSION: A retinal detachment developed in 6% of eyes after conservative treatment of retinoblastoma. The possibility of a rhegmatogenous origin should be considered even if no retinal break is detected. In the absence of tumor activity, a scleral buckling repair could be carefully considered if the retinal detachment threatens the macula, and if its evolution is not indicative of an exudative detachment.- - - - - - - - - - ranking = 1keywords = retinal detachment, detachment (Clic here for more details about this article) |
2/41. retinoblastoma with acute lymphoblastic leukemia, polyposis coli, and multiple hamartomas.It has long been recognized that compared with their age- and sex-matched controls, survivors of hereditary retinoblastoma have a considerably higher risk of the development of second malignancies (10% at 20 years and 15% at 30 years of follow-up), including osteosarcoma, leiomyosarcoma, melanoma, fibrosarcoma, and other rare spindle cell sarcomas. patients with the nongenetic variety of retinoblastoma do not particularly seem to have an increased incidence of other malignancies than the general population. However, it should be noted that a child with unilateral disease carries a 15% chance of having germline mutation. The cumulative mortality rate from second malignancies was 1.5% at 40 years after unilateral retinoblastoma diagnosis and 26% for bilateral cases in a large survey of 1458 patients. A child with unilateral retinoblastoma, cafe au lait spots, hairy nevus, and grouped pigmentation of retina in the fellow eye is described who furthermore developed acute leukemia and polyposis coli.- - - - - - - - - - ranking = 0.00010513296852059keywords = pigment (Clic here for more details about this article) |
3/41. Presumed rhegmatogenous retinal detachment in patients with retinoblastoma.PURPOSE: To review the characteristics, treatment, and outcome of presumed rhegmatogenous retinal detachment (RD) in patients with retinoblastoma. methods: Descriptive consecutive case series study from 1970 to 1996. RESULTS: Of 45 eyes with retinoblastoma that received various modalities of eye-sparing treatment and adequate follow-up, five developed presumed rhegmatogenous RD after treatment. All five eyes had previous treatment with external beam radiation, four of which also had been treated with cryotherapy. To minimize the potential spread of the malignancy intraoperatively, long disease-free intervals were ensured before scleral buckling surgeries were performed, and special care was taken during subretinal fluid drainage. The RDs were totally reattached in three eyes and partially reattached in the other two. CONCLUSION: Presumed rhegmatogenous RD may occur after external beam radiation or cryotherapy for retinoblastoma. It poses special challenges in management.- - - - - - - - - - ranking = 0.36189920673729keywords = retinal detachment, detachment (Clic here for more details about this article) |
4/41. Repair of late retinal detachment after successful treatment of retinoblastoma.PURPOSE: To analyze the results of vitreous surgery for late retinal detachment (RD) after successful treatment of retinoblastoma. methods: The records of all patients with retinoblastoma seen at a single ocular oncology service between 1982 and 1998 were reviewed to identify patients treated for late RD. Previous treatments, characteristics of the RD, surgical techniques used, and visual and anatomic results of the surgery were recorded. RESULTS: Of more than 500 charts reviewed, four patients treated for late RD were identified. All four had received previous, whole-eye, external beam radiotherapy and subsequently required cataract surgery. Other previous treatments included radioactive plaque, cryotherapy, xenon photocoagulation, and chemotherapy. At presentation, some patients had shifting subretinal fluid. None had a tear identifiable preoperatively, but two patients had a definite small slit tear at a tumor edge identified at surgery. One patient had a primary scleral buckle that failed. All patients had vitreous surgery with silicone oil. Average postsurgical follow-up was 30 months. Preoperative visual acuity ranged from 20/80 to light perception and improved postoperatively in two patients. The retina remained completely attached in three patients. CONCLUSIONS: Despite shifting subretinal fluid and no identifiable tear, a rhegmatogenous RD should be considered if it occurs late in patients with otherwise stable, treated retinoblastoma. Tumor reactivation must be excluded carefully. Vitreous surgery can be used to repair the RD successfully and improve vision.- - - - - - - - - - ranking = 0.36189920673729keywords = retinal detachment, detachment (Clic here for more details about this article) |
5/41. Rhegmatogenous retinal detachment in retinoblastoma patients undergoing chemoreduction and cryotherapy.PURPOSE: To report the development of rhegmatogenous retinal detachment, with the retinal break adjacent to a cryotherapy scar, in three patients undergoing systemic chemotherapy for intraocular retinoblastoma. METHOD: Case series. RESULTS: Three patients with intraocular retinoblastoma were referred after poor response to systemic chemotherapy and local cryotherapy; three eyes of these three patients were noted to have rhegmatogenous retinal detachment and active retinoblastoma, with retinal breaks adjacent to cryotherapy scars. CONCLUSION: Rhegmatogenous retinal detachment may result from retinal necrosis associated with cryotherapy in the setting of intraocular retinoblastoma treated with systemic chemotherapy and local cryotherapy.- - - - - - - - - - ranking = 0.50665888943221keywords = retinal detachment, detachment (Clic here for more details about this article) |
6/41. scleral buckling in retinoblastoma: case report.In the course of treating retinoblastoma in a monocular child, a progressive retinal detachment occurred. Although no retinal break was demonstrated, several clinical features suggested that the detachment was rhegmatogenous. A successful scleral buckling procedure was performed without adverse sequelae. The rationale for this approach is discussed.- - - - - - - - - - ranking = 0.10524031730508keywords = retinal detachment, detachment (Clic here for more details about this article) |
7/41. Retina pathology of a failed external beam-radiated group Vb retinoblastoma.We report on a 7-month-old boy who suffered from retinoblastoma with presentation of a white pupillary reflex in his right eye. Initial examination showed a large subretinal and intraretinal mass nasally with extensive vitreous seeding of tumor cells (Group Vb in the Reese-Ellsworth classification). External beam radiation therapy (EBRT) was applied in hopes of preserving the eye, and significant regression with disappearance of vitreous seedings and a prominently decreased tumor mass with localized calcification were documented. Unfortunately total retinal detachment was subsequently identified 3 months after irradiation. The patient ultimately underwent enucleation, and histopathology revealed significant calcification within the residual tumor without marked necrosis; a preretinal fibrous membrane with focal vascular thickening was noted, which implied a partial but incomplete effect of EBRT for this group Vb retinoblastoma. We describe the histopathological findings of the failure of irradiation for a group Vb retinoblastoma, and emphasize the importance of early application of EBRT treatment for a retinoblastoma.- - - - - - - - - - ranking = 0.072379841347458keywords = retinal detachment, detachment (Clic here for more details about this article) |
8/41. Eyelid and scleral necrosis following bare iridium-192 seed for retinoblastoma.A 2 1/2-year-old girl with a history of bilateral retinoblastoma underwent primary enucleation of the right eye and was referred for further management of persistent tumor in the fellow eye. Previous treatment of the left eye included external beam radiotherapy, systemic chemotherapy, laser photocoagulation, cryotherapy, and direct scleral application of a bare iridium-192 radioactive seed. Examination revealed focal full-thickness necrosis of the left upper and lower eyelid and a large inferonasal viable retinoblastoma tumor with overlying retinal detachment. Systemic chemotherapy and direct laser photocoagulation were administered. Four months after presentation, the patient developed focal scleral necrosis with 360 degrees hemorrhagic choroidal detachment. Enucleation was performed and histopathologic examination demonstrated full-thickness scleral necrosis with adjacent viable retinoblastoma tumor cells. Follow-up examinations showed no evidence of recurrent or metastatic tumor. This case is the first report of scleral necrosis following combined modality treatment of retinoblastoma.- - - - - - - - - - ranking = 0.10524031730508keywords = retinal detachment, detachment (Clic here for more details about this article) |
9/41. Unusual echographic form of retinoblastoma.A case of an 8-year-old girl with unilateral retinoblastoma is presented. The clinical picture was dominated by inflammatory signs and retinal detachment. Ultrasonographic A/B-scan showed a funnel-shaped total retinal detachment and a thick solid mass with similar shape just behind it. The main characteristics of the mass were: irregular inside echo pattern, medium high internal reflectivity, no sign of vascularity, no after movements following a sudden ocular movement, and no shadowing of the scleral or orbital tissues behind it. The vitreous cavity in front of the retina and behind the mass was ultrasonographically clear. The described funnel-shaped echographic pattern might be typical of the diffuse infiltrating retinoblastoma.- - - - - - - - - - ranking = 0.14475968269492keywords = retinal detachment, detachment (Clic here for more details about this article) |
10/41. High-frequency ultrasound of anterior segment retinoblastoma.PURPOSE: To evaluate anterior segment retinoblastoma with high-frequency ultrasound. DESIGN: Interventional case report. methods: An 11-year-old boy with a total retinal detachment and multiple white anterior chamber nodules was examined with high-frequency ultrasound before enucleation of the globe. RESULTS: Multiple solid and cystic nodular tumors were found in the anterior chamber angle. With high-frequency ultrasound, tumor was discovered posterior to the iris, over the ciliary processes, and on the lens capsule. No calcifications were noted. Other findings included angle closure related to iris neovascularization and uveal thickening. CONCLUSION: High-frequency ultrasound can be used to evaluate retinoblastoma extension into the anterior segment. These images may be used for comparison in future cases of retinoblastoma with anterior chamber invasion.- - - - - - - - - - ranking = 0.072379841347458keywords = retinal detachment, detachment (Clic here for more details about this article) |
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