Retinoblastoma services provides professional expertise in diagnosis and treatment of retinoblastoma- a curable childhood eye cancer if treated early and appropriately. Newer management modalities available in our center help in preserving eye and vision. Treatment of retinoblastoma is an art.
Most common symptom is ‘White Reflex'
Other common symptoms are squinting of eyes and enlarged eyeball due to increase in eye pressure.
Currently it is classified into different groups depending upon the extent of involvement.
≤ 3mm in basal diameter or thickness
atleast 3mm from the foveola and 1.5mm from the optic disc
≥ 3mm in basal diameter or thickness
macular location (≤ 3mm to foveola)
juxtapapillary location (≤ 1.5mm to disc)
|C||focalsubretinal and vitreous seeds ≤ 3mm from the tumor
|D||diffusesubretinal and vitreous seeds ≥3mm from the tumor|
extensive intraocular tumor occupying > 2/3 of the globe
massive intraocular hemorrhage, hyphema, hypopyon
aseptic orbital cellulitis, tumor touching the lens, anterior to the anterior vitreous face, diffuse infiltrating retinoblastoma
phthisis or pre-phthisical eye
yellow - tumor; blue - fluid around the tumor; orange dots - subretinal seeds; green dots - vitreous seeds
Management of retinoblastoma depends on the stage of the disease as stated in the classification.
The introduction of intravenous chemotherapy- ‘chemoreduction’ was path breaking in the management of the dreadful childhood cancer, essentially increasing the survival rate and preserving, function and vision. Chemoreduction reduces the size of the tumor and makes it amenable for local treatment. Intravenous chemotherapy alone is not curative, but always combined with intensive local therapy. Chemoreduction is safe if administered under the supervision and care of pediatric oncologist.
Eyes treated with systemic chemotherapy and transpupillary thermotherapy (TTT).
We strive to save eyes with our treatment approach in advanced intraocular disease.
It is the most advanced interventional procedure and a novel technique designed to combat RB locally and directly. In this technique chemotherapeutic agents are delivered directly to the tumor via ophthalmic artery. The results are promising in saving eyes with least systemic side effects. Another targeted treatment is the intravitreal delivery of chemotherapeutic agents to treat eyes with vitreous involvement in retinoblastoma, those that were otherwise enucleated earlier. The combined use of intravitreal chemotherapy and intra- arterial chemotherapy cautiously and judiciously by experts helps in saving eye and vision.
Newer treatment modalities used safely and effectively has improved the outcome in advanced intraocular disease and helps save eyes.
Eyes and vision can be preserved after a combination of intra-arterial chemotherapy and adjuvant intravitreal chemotherapy.
Removal of an eye is important when life is at risk in retinoblastoma. After removal, children are given natural looking artificial eyes with excellent cosmetic outcome.
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