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. 2012;7(4):e34120.
doi: 10.1371/journal.pone.0034120. Epub 2012 Apr 24.

Ophthalmic artery chemosurgery for less advanced intraocular retinoblastoma: five year review

David H Abramson  1 , Brian P Marr, Scott E Brodie, Ira Dunkel, Sotiria Palioura, Y Pierre Gobin
Affiliations

Ophthalmic artery chemosurgery for less advanced intraocular retinoblastoma: five year review

David H Abramson et al. PLoS One. 2012.

Abstract

Background: Ophthalmic artery chemosurgery (OAC) for retinoblastoma was introduced by us 5 years ago for advanced intraocular retinoblastoma. Because the success was higher than with existing alternatives and systemic side effects limited we have now treated less advanced intraocular retinoblastoma (Reese-Ellsworth (RE) I-III and International Classification Retinoblastoma (ICRB) B and C).

Methodology/principal findings: Retrospective review of 5 year experience in eyes with Reese Ellsworth (Table 1) I (7 eyes), II (6 eyes) or III (6 eyes) and/or International Classification (Table 2) B (19 eyes) and C (11 eyes) treated with OAC (melphalan with or without topotecan) introduced directly into the ophthalmic artery. Patient survival was 100%. Ocular event-free survival was 100% for Reese-Ellsworth Groups I, II and III (and 96% for ICRB B and C) at a median of 16 months follow-up. One ICRB Group C (Reese-Ellsworth Vb) eye could not be treated on the second attempt for technical reasons and was therefore enucleated. No patient required a port and only one patient required transfusion of blood products. The electroretinogram (ERG) was unchanged or improved in 14/19 eyes.

Conclusions/significance: Ophthalmic artery chemosurgery for retinoblastoma that was Reese-Ellsworth I, II and III (or International Classification B or C) was associated with high success (100% of treatable eyes were retained) and limited toxicity with results that equal or exceed conventional therapy with less toxicity.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Digital fundus images of three retinoblastoma eyes before (left panel) and after (right panel) ophthalmic artery chemosurgery showing dramatic shrinkage of tumors without toxicity to the rest of the eye(s).
See this image and copyright information in PMC

References

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