Clinic analysis of rhegmatogenous retinal detachment secondary to conservative therapy in retinoblastoma patients

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-09-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.05.007

Xunda Ji, Jia-Kai Li, Tingyi Liang, Xiuyu Zhu, Xuehao Cui

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Abstract

Objective To observe the clinical characteristics of rhegmatogenous retinal detachment (RRD) secondary to conservative therapy in retinoblastoma (RB) patients. Methods A retrospective study. From July 2013 to May 2017, 20 RRD patients (20 eyes) of 456 RB patients (573 eyes) treated in Xinhua Hospital of Shanghai Jiao Tong University School of Medicine were included in the study. Eleven patients (11 eyes) were boy and 9 patients (9 eyes) were girls. Thirteen patients demonstrated bilateral RB and 7 patients had unilateral RB. Average age when diagnosed with RB was 25 months. International Classification of Retinoblastoma groups were C in 1 eye, D in 17 eyes, and E in 2 eyes. These patients received intra-arterial chemotherapy (17 eyes), intravenous chemotherapy (11 eyes), intravitreal chemotherapy (8 eyes), laser (14 eyes) and/or cryotherapy (5 eyes). Twelve patients (12 eyes) received vitreoretinal surgery including vitrectomy (6 eyes) and scleral buckling (7 eyes). The mean follow-up was 39 months. Fundus examination was performed under general anesthesia during comprehensive treatment and follow-up. The time interval of fundus examination varied from 1 to 6 months depending on the stability of the tumor. Results RRD was noted in 20 eyes (3.5%) with RB. Retinal hole was found in 15 eyes (75%). The cause of RRD was atrophic hole in calcified tumor (6 eyes, 30%), cryotherapy-related hole (5 eyes, 25%) and laser-related hole (9 eyes, 45%). Multiple atrophic hole in calcified tumor was noted in 3 eyes. Size of hole smaller than 2 DD was noted in 8 eyes (53%), and larger than 2 DD was noted in 7 eyes (47%). Holes were in posterior (3 eyes), equator (2 eyes) and periphery (10 eyes). Severe proliferated was noted in 1 eye. No tear was found. No bulbar retinal detachment and choroidal detachment was noted. Among 12 eyes who underwent vitreoretinal surgery, reattachment was achieved in 9 eyes (75%). No metastasis was noted. Conclusions Calcified regression of tumor, cryotherapy and laser were main reasons of RRD. Most of the holes are small in diameter and located in the periphery. Key words: Retinoblastoma; Retinal detachment; Chemotherapy, cancer, regional perfusion; Laser coagulation; Cryotherapy

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视网膜母细胞瘤保守治疗继发孔源性视网膜脱离的临床分析

目的观察视网膜母细胞瘤（RB）保守治疗后孔源性视网膜脱离（RRD）的临床特点。方法回顾性研究。2013年7月至2017年5月，在上海交通大学医学院新华医院接受治疗的456名RB患者（573眼）中，20名RRD患者（20眼）被纳入研究。11例（11只眼）为男孩，9例（9只眼）为女孩。13例患者出现双侧RB，7例患者出现单侧RB。诊断为RB的平均年龄为25个月。视网膜母细胞瘤的国际分类为C组1眼，D组17眼，E组2眼。这些患者接受了动脉内化疗（17眼）、静脉化疗（11眼）、玻璃体内化疗（8眼）、激光（14眼）和/或冷冻治疗（5眼）。12例（12眼）接受了玻璃体视网膜手术，包括玻璃体切除术（6眼）和巩膜扣带术（7眼）。平均随访39个月。在综合治疗和随访期间，在全身麻醉下进行眼底检查。眼底检查的时间间隔从1到6个月不等，这取决于肿瘤的稳定性。结果RB患者20眼（3.5%）出现RRD。视网膜裂孔15眼（75%）。RRD的病因是钙化瘤萎缩性空洞（6眼，30%）、冷冻治疗相关空洞（5眼，25%）和激光相关空洞（9眼，45%）。钙化瘤多发性萎缩性空洞3眼。8眼（53%）观察到孔尺寸小于2DD，7眼（47%）观察到大于2DD。孔在后部（3眼）、赤道（2眼）和周边（10眼）。1眼出现严重增殖。没有发现撕裂。未发现球视网膜脱离和脉络膜脱离。在接受玻璃体视网膜手术的12眼中，9眼（75%）实现了复位。未发现转移。结论肿瘤钙化消退、冷冻治疗和激光治疗是RRD的主要原因。大多数孔的直径较小，并且位于外围。关键词：视网膜母细胞瘤；视网膜脱离；化疗，癌症，局部灌注；激光凝固；冷冻疗法

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).