DR. ROLIKA BANSAL

DR. KAUSTUBH MULAY, DR. SANTOSH G. HONAVAR

Abstract

Purpose:To assess the histopathological risk-factors (HRF) in advanced retinoblastoma(Rb) after triple drug super-selective ophthalmic artery intra-arterial chemotherapy(IAC)

Methods:Retrospective interventional consecutive case series

Results: 129Rb eyes received IAC(mean cycles 2.4). Secondary enucleation was done for 42(32%)[13(31%) primary IACs; 29(69%)secondary] with baseline classification of groupD 13(31%) & groupE 22(52%); due to refractory tumor 22(52%), sub-optimal response 10(24%) and recurrence 10(24%). Only 13(31%) had HRF (3primary,10secondary IACs) as iris infiltration 1(7%), ciliary body 2(15%), choroid(>3 mm) 10(77%); optic nerve retrolaminar 2(15%), scleral lamellar 4(30%) & extra-scleral 1(7%). All received adjuvant chemotherapy. Life salvage was seen in 42(100%) at 35.3+25.8m follow-up

Conclusion:IAC is an effective modality for advanced Rb with few cases requiring enucleation. Assessment of HRF predicts metastasis & advocates adjuvant therapy to ensure life salvage