Two-Year Clinical Outcomes of Pars Plana Vitrectomy as initial treatment
for Refractory Retinoblastoma Vitreous Seeding and concurrent retinal
detachment: A Retrospective Case Series Study
Abstract
Abstract Purpose To evaluate the safety and efficacy of pars plana
vitrectomy (PPV) for recalcitrant vitreous seeding from retinoblastoma
and concurrent retinal detachment. Methods In this retrospective
interventional case series, intravitreal chemotherapy-assisted PPV was
performed in 6 patients with persistent retinoblastoma vitreous seeds
and concurrent retinal detachment. Globe salvage, retinal reattachment,
and visual preservation at last follow-up visit were calculated. Results
Six eyes, initially classified as group D (n=4) or E (n=2) with sphere
and (or) cloud vitreous seeds, received standard systemic with
intravitreal chemotherapy and subsequently developed refractory vitreous
seeds with concurrent retinal detachment. PPV produced complete
elimination of vitreous seeds in all 6 eyes and no vitreous seeding
recurred over a mean follow-up of 29.6 months. Globe salvage and
complete retina reattachment were attained in all 6 eyes (100%). Last
follow-up vision acuity was assessable in 4 eyes with 80% (3/4) better
than 0.4. Three eyes (50%) received repeated systemic or focal
treatment because of the recurrent retinal tumor. There was no case of
extraocular tumor extension or systemic metastasis. Conclusion
Administration of intravitreal chemotherapy-assisted PPV appears to be a
safe and effective alternation for the initial treatment of refractory
vitreous seeds from retinoblastoma. It is also a promising therapeutic
strategy to repair concurrent retinal detachment and preserve the
remaining visual function.