Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-01-28DOI: 10.1080/08820538.2025.2457043
Rachel M Malsch, Rachael B Tessem, Lauren A Dalvin
{"title":"Insights from the First Five Years of the Prospective Ocular Tumor Study.","authors":"Rachel M Malsch, Rachael B Tessem, Lauren A Dalvin","doi":"10.1080/08820538.2025.2457043","DOIUrl":"10.1080/08820538.2025.2457043","url":null,"abstract":"<p><strong>Purpose: </strong>Standardized data collection is needed to improve research for rare diseases. In this manuscript, we describe our experience establishing the Prospective Ocular Tumor Study (POTS).</p><p><strong>Methods: </strong>The ongoing POTS captures all patients with an ocular tumor seen on the Ocular Oncology Service at Mayo Clinic Rochester and collects patient demographics, tumor features, treatment, and outcomes. This manuscript reports data collected from July 2019-July 2024.</p><p><strong>Results: </strong>During a 5-year time period, 1,766 patients enrolled in the database, with 975 (55%) females, 1,732 (98%) white race, and mean age 61.5 years. The most frequent tumor types were choroidal melanoma (<i>n</i> = 610 [34%]), choroidal nevus (<i>n</i> = 575 [32%]), iris nevus (<i>n</i> = 95 [5.3%]), iris melanoma (<i>n</i> = 46 [2.6%]), and vitreoretinal lymphoma (<i>n</i> = 46 [2.6%]).</p><p><strong>Conclusion: </strong>The POTS is a valuable source of detailed, longitudinal data on rare ocular tumors. Expanding standardized data collection across multiple centers will facilitate improved outcomes research in ocular oncology.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"508-517"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2024-12-31DOI: 10.1080/08820538.2024.2447724
Mattan Arazi, Jonathan Kfir, Alia Ahmad, Allen Foster, Alona Baum, Andrew W Stacey, Andrey A Yarovoy, Arturo Manuel Zapata López, M Ashwin Reddy, Brianne Brown, Covadonga Bascaran, Deborah Im, Fahmida Huque, Jesse L Berry, Juan Garcia, Lamis Al Harby, Mandeep S Sagoo, Marcia Zondervan, Matthew Burton, Nathalie Cassoux, Nicholas John Astbury, Nir Gomel, Richard Bowman, Riffat Rashid, Rosdali Diaz Coronado, Sadia Sultana, Sadik Taju Sherief, Sharon Blum, Soma Rani Roy, Swathi Kaliki, Tatiana Ushakova, Vera A Yarovaya, Vladimir G Polyakov, Xunda Ji, Ido Didi Fabian
{"title":"Primary Enucleation for Intraocular Unilateral Retinoblastoma Can Save Life in Lower-Income Settings.","authors":"Mattan Arazi, Jonathan Kfir, Alia Ahmad, Allen Foster, Alona Baum, Andrew W Stacey, Andrey A Yarovoy, Arturo Manuel Zapata López, M Ashwin Reddy, Brianne Brown, Covadonga Bascaran, Deborah Im, Fahmida Huque, Jesse L Berry, Juan Garcia, Lamis Al Harby, Mandeep S Sagoo, Marcia Zondervan, Matthew Burton, Nathalie Cassoux, Nicholas John Astbury, Nir Gomel, Richard Bowman, Riffat Rashid, Rosdali Diaz Coronado, Sadia Sultana, Sadik Taju Sherief, Sharon Blum, Soma Rani Roy, Swathi Kaliki, Tatiana Ushakova, Vera A Yarovaya, Vladimir G Polyakov, Xunda Ji, Ido Didi Fabian","doi":"10.1080/08820538.2024.2447724","DOIUrl":"10.1080/08820538.2024.2447724","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the outcomes of primary enucleation and adjuvant systemic chemotherapy, when deemed appropriate, on a cohort of children with unilateral intraocular Rb (AJCC 8th edition, cT2 and cT3) from diverse economic groupings.</p><p><strong>Methods: </strong>A prospective analysis including treatment-naïve Rb patients were presented to 11 centers from 10 countries from January 1 to December 31, 2019, and were followed-up thereafter. Only children with unilateral intraocular Rb that underwent primary enucleation were included in the present analysis. Systemic metastasis and survival were investigated.</p><p><strong>Results: </strong>Of the 692 children with Rb, 191 (27.6%) were included in the study cohort. Among them, 24 (12.6%) were from low-income countries (LICs), 89 (46.6%) from lower-middle-income countries (LMICs), 59 (30.9%) from upper-middle-income countries (UMICs), and 19 (9.9%) from high-income countries (HICs). High-risk histopathological features were observed in 110 eyes (57.6%) following enucleation, and 102 of these children (92.7%) received adjuvant intravenous chemotherapy. The three-year survival rate for the entire cohort was 95.0%. Stratified by economic grouping, survival rates were 87.5% (LIC), 96.6% (LMIC), 93.2% (UMIC), and 100% (HIC). Children from LICs demonstrated a higher prevalence of HRHF compared to HICs. Residing in a lower-income country was associated with a higher risk of systemic metastasis and poorer outcomes.</p><p><strong>Conclusion: </strong>In the present multinational cohort of children with unilateral intraocular Rb who underwent upfront enucleation coupled with adjuvant chemotherapy as needed, overall survival was favorable, especially for children from low-income countries. Prompting early diagnosis, while the tumor remains intraocular can be life-saving, particularly in low-resource settings where primary enucleation and adjuvant chemotherapy can cure unilateral Rb.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"496-500"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-02-09DOI: 10.1080/08820538.2025.2458658
Wendy J Li, Wisam Najdawi, Omar Badla, Anat Galor, Carol L Karp
{"title":"Immune Checkpoint Inhibitors in the Treatment of Ocular Surface Cancers: A Review.","authors":"Wendy J Li, Wisam Najdawi, Omar Badla, Anat Galor, Carol L Karp","doi":"10.1080/08820538.2025.2458658","DOIUrl":"10.1080/08820538.2025.2458658","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by targeting key immune pathways such as PD-1, PD-L1, CTLA-4, and LAG-3 to enhance the immune system's ability to combat malignancies. Their use in treating ocular surface tumors is an emerging area of interest, particularly in conjunctival melanoma (CM) and ocular surface squamous neoplasia (OSSN). Some studies have indicated the potential of ICI's in sebaceous gland carcinoma (SeC), conjunctival lymphoma, and Kaposi sarcoma.</p><p><strong>Purpose: </strong>This review aims to evaluate the role of ICIs in treating ocular surface tumors, focusing on their mechanisms of action, clinical outcomes, and therapeutic potential.</p><p><strong>Methods: </strong>A literature review was conducted by searching Pubmed for studies published between January 2014 and October 2024. Studies included were original research, clinical trials, case reports and series, and reviews.</p><p><strong>Results: </strong>ICIs, including pembrolizumab and nivolumab, have shown promising results in CM, achieving tumor regression and disease stabilization in advanced and metastatic cases. ICIs have also demonstrated efficacy in OSSN, particularly in lesions with high tumor mutational burden, with responses ranging from partial to complete resolution. Although clinical data for SeC and conjunctival lymphoma remain limited to isolated reports, these studies suggest a role for ICIs in managing refractory or advanced disease.</p><p><strong>Conclusion: </strong>ICIs hold transformative potential in improving outcomes for ocular surface malignancies, particularly in cases where conventional treatments fail or pose significant morbidity. Despite their promise, challenges persist, including variable response rates, immune-related adverse events, and the need for reliable predictive biomarkers. Comprehensive prospective studies are necessary to refine the application of ICIs, optimize treatment strategies, and expand therapeutic options for these challenging cancers.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"485-495"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-01-22DOI: 10.1080/08820538.2025.2452088
Mohammad Javed Ali, Peter John Wormald
{"title":"Lacrimal History - Part 36: Doyens of Dacryology Series - Michael McDonogh.","authors":"Mohammad Javed Ali, Peter John Wormald","doi":"10.1080/08820538.2025.2452088","DOIUrl":"10.1080/08820538.2025.2452088","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"449-450"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-03-18DOI: 10.1080/08820538.2025.2479781
Alyssa C Bonnell, Laura D Selby, Minh T Nguyen, Jonathan Chen, Alexei V Chvetsov, Andrew W Stacey
{"title":"Adjuvant Brachytherapy Using Iodine-125 Plaques for Conjunctival Melanoma with Scleral Invasion.","authors":"Alyssa C Bonnell, Laura D Selby, Minh T Nguyen, Jonathan Chen, Alexei V Chvetsov, Andrew W Stacey","doi":"10.1080/08820538.2025.2479781","DOIUrl":"10.1080/08820538.2025.2479781","url":null,"abstract":"<p><strong>Purpose: </strong>To report a series of patients with unresectable conjunctival melanoma treated with surgical excision followed by adjuvant iodine-125 plaque brachytherapy.</p><p><strong>Methods: </strong>A retrospective review of a consecutive series of patients at one institution who were found to have scleral-invasive conjunctival melanoma and who were treated with adjuvant plaque brachytherapy. Pre-operative, radiation, and post-operative data were collected for each patient. Patients were evaluated for intraocular pressure, visual acuity (VA), radiation complications, local recurrence, and presence of metastatic disease.</p><p><strong>Results: </strong>A total of 9 patients met inclusion criteria. After surgical excision, all 9 patients were treated with iodine-125 plaque brachytherapy with a dose of 85 Gy to a depth of 3 mm from the plaque face for a prescribed dwell time of 2-3 days. Patients were followed for a median of 45 months (range: 3-66). There have been no local recurrences to this point. Following surgery, 4 of the 9 patients maintained a VA of 20/50 or better. Overall mean visual acuity declined from Snellen 20/59 preoperatively to 20/209 postoperatively. Limbal stem cell deficiency occurred in 3 patients (33%) but may be explained by additional treatments provided in each of these patients (mitomycin C eyedrops in two and proton beam radiation in one). One patient with a second, high-risk forniceal conjunctival melanoma developed metastatic disease.</p><p><strong>Conclusions: </strong>Plaque brachytherapy with iodine-125, delivering a dose of 85 Gy to a depth of 3 mm over a short period of time (3 days) provides safe and promising results for vision and tumor control in patients with scleral-invasive conjunctival melanoma.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"546-550"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-05-19DOI: 10.1080/08820538.2025.2507750
Carol L Shields, Madison Woods, Randy Calotti, Haley Evans, Robert Medina, Shady Mina, Jose E Pena, Ayra Khan, Henry Nguyen, Rolika Bansal, Hidayet Sener, Sara E Lally, Jerry A Shields
{"title":"Tumor Location of Uveal Melanoma and Impact on Metastasis-Free Survival in 1001 Cases.","authors":"Carol L Shields, Madison Woods, Randy Calotti, Haley Evans, Robert Medina, Shady Mina, Jose E Pena, Ayra Khan, Henry Nguyen, Rolika Bansal, Hidayet Sener, Sara E Lally, Jerry A Shields","doi":"10.1080/08820538.2025.2507750","DOIUrl":"10.1080/08820538.2025.2507750","url":null,"abstract":"<p><strong>Background: </strong>There is limited literature on tumor location of uveal melanoma (UM) and the relative impact on metastasis-free survival (MFS).</p><p><strong>Methods: </strong>A review of 1001 consecutive eyes with UM was performed and precise tumor location was identified according to quadrant (5 zones), clock hour (13 zones), anteroposterior (5 zones), and a combination of clock hour and anteroposterior regions (49 zones). Heat maps were constructed for frequency in each zone and Kaplan-Meier estimates for 5- and 10-year MFS was calculated.</p><p><strong>Results: </strong>The UM quadrant regions included central (macula and juxtapapillary) (18%), superior (19%), nasal (18%), inferior (18%), and temporal (27%). The central region demonstrated smaller UM thickness (<i>p</i> < .01) and diameter (<i>p</i> < .01). The MFS (5- and 10-years) for central region (90%, 86%) was more favorable than other quadrants (<i>p</i> < .01).The UM clock hour regions included central (18%), 1:00 (6%), 2:00 (6%), 3:00 (10%), 4:00 (6%), 5:00 (7%), 6:00 (7%), 7:00 (5%), 8:00 (7%), 9:00 (9%), 10:00 (6%), 11:00 (5%), and 12:00 (8%). The central region demonstrated smaller UM thickness (<i>p</i> < .01) and diameter (<i>p</i> < .01). The MFS (5- and 10-years) for central region (90%, 86%) was more favorable than any clock hour region (<i>p</i> = .03).The UM anteroposterior regions included central (18%), post-equatorial (28%), equatorial (26%), peripheral (13%), and ciliary body (15%). Increasing UM thickness (<i>p</i> < .01) and diameter (<i>p</i> < .01) stepwise were noted with increasing anterior location. The MFS (5- and 10-years) for central region (90%, 86%) was more favorable than other anteroposterior regions (<i>p</i> < .01).A combination of clock hour and anteroposterior regions (49 zones) revealed random distribution with no preferential location. Multivariate regression analysis adjusted for tumor thickness/diameter and proximity to foveola/optic disc showed no benefit of any location.</p><p><strong>Conclusions: </strong>Across all fundus regions, UM occurred most often in the central region. Uveal melanoma in the central region was smaller in thickness and base and demonstrated more favorable MFS compared to other quadrants, clock hours, and anteroposterior zones. Analysis of the 49 zones showed no benefit of tumor location alone after adjusting for tumor size and proximity to foveola and optic disc.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"564-574"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nodulo-Ulcerative Ocular Surface Squamous Neoplasia in 27 Patients: Clinical Presentation, Management and Outcomes.","authors":"Vijitha S Vempuluru, Anshika Luthra, Prerna Sinha, Suneetha Gavara, Swathi Kaliki","doi":"10.1080/08820538.2024.2432908","DOIUrl":"10.1080/08820538.2024.2432908","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical presentation, management, and outcomes of nodulo-ulcerative ocular surface squamous neoplasia (nuOSSN).</p><p><strong>Methods: </strong>Retrospective interventional clinical cohort study of 27 patients from a quaternary ocular oncology center.</p><p><strong>Results: </strong>Twenty-seven patients were diagnosed with nuOSSN during the six-year study period. The mean age at presentation was 53 years (median, 51 years; range, 25 to 81 years). Misdiagnosis was noted in 7 (26%) patients, and the mean lag time from symptom onset to presentation at our center was 14 months (median, 6 months; range, 1 to 96 months). The bulbar conjunctiva was the commonest epicenter (<i>n</i> = 19, 70%), and the temporal quadrant was most commonly involved (<i>n</i> = 13, 48%). The mean tumor diameter and thickness were 18 mm (median, 16 mm; range, 8 to 60 mm) and 3 mm (median, 2 mm; range, 1 to 5 mm), respectively. Corneal, limbal, and scleral thinning were seen in 15 (56%), 18 (67%), and 10 (37%) patients, respectively. Peripheral corneal opacification was seen in 18 (67%), and thickening around the area of scleral thinning was seen in 12 (44%) patients. Tumors belonged to the American Joint Committee for Cancer classification T2 (<i>n</i> = 2, 7%), T3 (<i>n</i> = 19, 70%), and T4 (<i>n</i> = 6, 22%) categories. Primary treatment (<i>n</i> = 19) included topical 1% 5-fluorouracil (5FU) eye drops (<i>n</i> = 1, 4%), excisional biopsy (<i>n</i> = 4, 14%), extended enucleation (<i>n</i> = 11, 41%), and orbital exenteration (<i>n</i> = 3, 11%). At a mean follow-up of 9 months (median, 3 months; range 1 to 46 months) in 19 patients who received treatment, the outcomes included local tumor recurrence in 2 patients (11%), tumor control in 16 (84%), globe salvage in 3 (16%), and lymph node metastasis in 2 patients (11%).</p><p><strong>Conclusion: </strong>nuOSSN is an aggressive form of the disease that is frequently misdiagnosed due to the presence of corneoscleral thinning. Globe salvage rates are poor owing to the advanced stage of presentation.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"501-507"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-02-15DOI: 10.1080/08820538.2025.2467277
Linda A Cernichiaro-Espinosa, Benjamin A King, David Taylor Gonzalez, Cigdem Ozturk, Aleksander Kruglov, Rachel C Brennan, Ibrahim Qaddoumi, Carlos Rodriguez-Galindo, Matthew W Wilson, Mary E Hoehn
{"title":"Delayed Periocular and Anterior Segment Complications Following Locally Administered Chemotherapy for Vitreous Seeding in Retinoblastoma.","authors":"Linda A Cernichiaro-Espinosa, Benjamin A King, David Taylor Gonzalez, Cigdem Ozturk, Aleksander Kruglov, Rachel C Brennan, Ibrahim Qaddoumi, Carlos Rodriguez-Galindo, Matthew W Wilson, Mary E Hoehn","doi":"10.1080/08820538.2025.2467277","DOIUrl":"10.1080/08820538.2025.2467277","url":null,"abstract":"<p><strong>Background: </strong>Long-term follow-up is essential for retinoblastoma survivors, as treatment-related sequelae can emerge years after therapy.</p><p><strong>Methods: </strong>This case series reviews 67 eyes treated with periocular and/or intravitreal chemotherapy from 2005 through 2020.</p><p><strong>Results: </strong>Periocular chemotherapy was associated with orbital fibrosis in 79.1% of cases, with risk increasing concomitantly with the number of injections. Cataracts developed in 19.4% of eyes, with 10 out of 13 requiring cataract extraction. Other complications included chronic conjunctivitis and limbal stem cell deficiency (3% each), while strabismus was observed in 29.9% of which 7.5% underwent strabismus surgery. Comparative analyses of periocular and anterior segment complications from other retrospective studies are included to contextualize our findings.</p><p><strong>Conclusions: </strong>Understanding these long-term sequelae is crucial for appropriately following and managing retinoblastoma survivors who were treated during this era. We highlight the importance of vigilant surveillance as treatment protocols continue to evolve.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"529-537"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-02-20DOI: 10.1080/08820538.2025.2469975
Mohammad Javed Ali
{"title":"Lacrimal History - Part 38: Doyens of Dacryology Series - Rona Zel Silkiss (1957-) and Jennifer Anne Sivak-Callcott (1970-).","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2469975","DOIUrl":"10.1080/08820538.2025.2469975","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"455-457"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seminars in OphthalmologyPub Date : 2025-08-01Epub Date: 2025-05-07DOI: 10.1080/08820538.2025.2501796
Ali Al-Gilgawi, Zishan Naeem, Catriona Duncan, Fergus Robertson, Mandeep S Sagoo, M Ashwin Reddy
{"title":"Onset and Resolution of Ocular Motor Cranial Nerve Palsies Following the Use of Intra-Arterial Chemotherapy for Retinoblastoma.","authors":"Ali Al-Gilgawi, Zishan Naeem, Catriona Duncan, Fergus Robertson, Mandeep S Sagoo, M Ashwin Reddy","doi":"10.1080/08820538.2025.2501796","DOIUrl":"10.1080/08820538.2025.2501796","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-arterial chemotherapy (IAC) has revolutionised the treatment of retinoblastoma with respect to eye salvage. We present a case series assessing the onset and resolution of cranial nerve palsies following IAC in the treatment of retinoblastoma.</p><p><strong>Materials and methods: </strong>A retrospective case series examining children treated with IAC between 2014 and 2020 for refractory retinoblastoma. The initial approach to catheterisation was the same in all cases. All patients were assessed by an orthoptist and those with nerve palsies were followed up for resolution.</p><p><strong>Results: </strong>There were 41 patients treated with IAC in this time period with a median age of 15 months (5-125). Of these, 7 (17%) developed cranial nerve palsies (NP). These were either 3<sup>rd</sup> (3 of 7), 6<sup>th</sup> (1 of 7) or mixed 3<sup>rd</sup> and 6<sup>th</sup> (3 of 7) palsies. Onset was at a median of 5 days after the injection. Five resolved and resolution was at a median of 3 months (0.75-26) from onset. Two children still had extra-ocular muscle involvement due to NPs that did not resolve and the cumulative doses of Melphalan were 47.5 mg and 37.5 mg. All children who had cranial nerve palsies that resolved had a cumulative dose of less than 20 mg of Melphalan.</p><p><strong>Conclusion: </strong>Cranial nerve palsy is an infrequent occurrence after IAC but families need to be aware of this as a complication. It is reassuring that the majority resolve. In our experience, a high cumulative dose of melphalan due to the refractory nature of the tumour increases the risk of this complication long term.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"558-563"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}