MACULOPATHY AND CHORIORETINOPATHY IN CHILDREN WITH RETINOBLASTOMA RECEIVING CHEMOTHERAPY: CLINICAL TRIALS AND MORPHOMETRIC ANALYSIS



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Abstract

Purpose. This research is to evaluate patients with retinoblastoma, who receive chemotherapy, with Spectralis optical coherence tomography with enhanced depth imaging to compare the signs of chorioretinopathy and maculopathy. Material and methods. 74 patients were examined and treated, 125 eyes with retinoblastoma in age at average of 24 ± 1.6 months. Group 1 - 31 patients, 62 eyes after intravenous chemotherapy, 2 - 24 patients, 25 eyes after intravenous and superselective intraarterial or intravitreal chemotherapy. Group 3 (control) - 19 patients (38 eyes) with primary retinoblastoma. The condition of the retina, choroid and macula was assessed using Ret Cam II and Spectralis optical coherence tomography with enhanced depth imaging. All patients had complete tumor resorption after treatment. Results. In group 1, after 3 courses of chemotherapy Spectralis optical coherence tomography with enhanced depth imaging showed a decrease of caliber of retinal vessels; wavelength of photoreceptors, hyperreflective round foci and calcinates in the retinal pigment epithelium; choriocapillary hyperreflexivity, choroid thinning; in the sclera - hyperreflective foci with visualization of the scleral vessels. In the macula - disorganization of retinal pigment epithelium, cystic edema, smoothness of the papillomacular bundle, coracoid form of the fovea, retinal thickening. After 3 courses of systemic chemotherapy and superselective intraarterial chemotherapy (group 2) - peritumoral increase in the caliber of retinal vessels. After systemic superselective intraarterial and intravitreal chemotherapy (group 2) - epiretinal membranes, punctate hyperreflective foci in the inner layers of the retina. In group 3 (control), before treatment, a normal anatomical and topographic state of the macula was observed with extracentral localization of retinoblastoma. Conclusions. Profound morphometric disturbances that come with combined chemotherapy (intravenous, superselective intraarterial and intravitreal chemotherapy treatments) call for a more careful treatment with methods selected in terms of Spectralis optical coherence tomography with enhanced depth imaging findings and specific chemotherapy contraindications.

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About the authors

S. V Saakyan

The Helmholtz Moscow Research Institute of Eye Diseases Russian Ministry of Health

105062, Moscow, Russian Federation

Elena В. Myakoshina

The Helmholtz Moscow Research Institute of Eye Diseases Russian Ministry of Health

Email: myakoshina@mail.ru
PhD, researcher at the Department of Radiology and ophthalmooncology, Moscow Helmholtz Research Institute of Eye Diseases 105062, Moscow, Russian Federation

V. G Polyakov

«N.N. Blokhin Russian Cancer Research Center»

Moscow, 115211, Russian Federation

T. L Ushakova

«N.N. Blokhin Russian Cancer Research Center»

Moscow, 115211, Russian Federation

D. M Ismailova

The Helmholtz Moscow Research Institute of Eye Diseases Russian Ministry of Health

105062, Moscow, Russian Federation

References

  1. Бровкина А.Ф. Офтальмоонкология. М: Медицина; 2002.
  2. Саакян С.В. Ретинобластома (клиника, диагностика, лечение). М.: Медицина. 2005.
  3. Бровкина А.Ф, Пантелеева О.Г. Результаты лечения ретинобластомы. Вестник офтальмологии.1995; 111 (3): 12-4.
  4. Саакян С.В., Мякошина Е.Б., Кричевская Г.И., Слепова О.С. Ретинобластома и «псевдоретинобластома» у детей: клинические, томографические и серологические особенности. Вестник офтальмологии. 2014; 1: 18-24.
  5. Саакян С.В. Современные подходы к лечению ретинобластомы. Российский офтальмологический журнал.2008;1:33-8.
  6. Shields C. L. Retinoblastoma. Jaypee Brothers Medical Bublishers (P) Ltd; 2012.
  7. Abramson D.H. Retinoblastoma 1990: diagnosis, treatment and implications. Pediatr. Ann.1990; 19 (6): 387-95.
  8. Щеглов В.И., Щеглов Д.В., Рыбальченко С.В., Склярова А.И. Глазные осложнения у пациентов получавших химиотерапию внутриартериально в составе комплексного лечения глиом головного мозга супратенториальной локализации. Ендоваскулярна нейрорентгенохірургія. 2014;3(9): 22-7.
  9. Zlioba A., Peyman G.A., Nikoleit J. Retinal toxicity study of intravitreal carboplatin and iproplatin. Ann Ophthalmol. 1988;20: 71-2.
  10. Munier F.L., Beck-Popovic M., Balmer A., Gaillard M-C., Bovey E., et al. Occurrence of sectoral choroidal occlusive vasculopathy and retinal arteriolar embolization after superselective ophthalmic artery chemotherapy for advanced intraocular retinoblastoma. Retina (Philadelphia, Pa) 2011;31: 566-73. DOI identifier: 10.1097/IAE.0b013e3182265198
  11. Wilson M.W., Jackson J.S., Phillips B.X., Buchanan J., Frase S., et al. Real-time ophthalmoscopic findings of superselective intraophthalmic artery chemotherapy in a nonhuman primate model. Arch Ophthalmol. 2011;129: 1458-65. doi: 10.1001/archophthalmol. 2011. 330
  12. Bianciotto C., Shields C.L., Iturralde J.C., Sarici A., Jabbour P., et al. Fluorescein angiographic findings after intra-arterial chemotherapy for retinoblastoma. Ophthalmology. 2012; 119: 843-9. DOI: http://dx.doi.org/10.1016/j.ophtha.2011.09.040
  13. Tse B.C., Steinle J.J., Johnson D., Haik B.G., Wilson M.W. Superselective Intraophthalmic Artery Chemotherapy in a Nonhuman Primate Model: Histopathologic Findings. JAMA Ophthalmol. 2013; 1-8. doi: 10.1001/jamaophthalmol.2013.2065.
  14. Brodie S.E., Paulus Y.M. et al. ERG monitoring of retinal function during systemic chemotherapy for retinoblastoma. Br J Ophthalmol. 2012; 96: 877-880. doi: 10.1136/bjophthalmol-2011-301248
  15. Ueda M., Tanabe J., Suzuki T., Sakai H., Mochizuki K., et al. Conservative therapy for retinoblastoma-effect of melphalan on in vitro electroretinogram. Nippon Ganka Gakkai Zasshi. 1994; 98: 352-6.
  16. Brodie S.E., Pierre Gobin Y., Dunkel I.J., Kim J.W., Abramson D.H. Persistence of retinal function after selective ophthalmic artery chemotherapy infusion for retinoblastoma. Doc Ophthalmol. 2009; 119: 13-22. doi: 10.1007/s10633-012-9358-6. Epub 2012 Nov 11.
  17. Brodie S.E., Munier F,L., Francis J.H., Marr B., Gobin Y.P., Abramson D.H. Persistence of retinal function after intravitreal melphalan injection for retinoblastoma. Doc Ophthalmol. 2013 Feb; 126(1): 79-84. doi: 10.1007/s10633-012-9358-6.
  18. Зуева М.В., Цапенко И.B., Саакян С.В., Пантелеева О.Г., Жаруа А.А., Орловская Л.С. Вызванные потенциалы сетчатки и зрительной коры у детей с далеко зашедшей и резистентной ретинобластомой после неоадъювантной полихимиотерапии и суперселективной внутриартериальной химиотерапии. Вестник офтальмологии. 2014; 5: 22-9.
  19. Нероев В.В., Саакян С.В., Мякошина Е.Б., Тацков Р.А., Зайцева О.В., Рябина М.В. Первый опыт применения оптической когерентной томографии в диагностике первичной и остаточной ретинобластомы. Вестн. офтальмол. 2012; 2: 8-12.
  20. Саакян С.В., Тацков Р.А., Мякошина Е.Б. Начальная ретинобластома: ранняя диагностика и комбинированное органосохраняющее лечение (обзор литературы). Вестник офтальмологии. 2012; 2: 55-60.
  21. Samara W.A., Pointdujour-Lim R., Say E.A., Shields CL. Foveal microanatomy documented by SD-OCT following treatment of advanced retinoblastoma. J. AAPOS. 2015; 19(4): 368-72. doi: 10.1016/j.jaapos.2015.02.019. Epub 2015 Jul 30
  22. Cao C., Markovitz M., Ferenczy S., Shields C.L. Hand-held spectral-domain optical coherence tomography of small macular retinoblastoma in infants before and after chemotherapy. J Pediatr Ophthalmol Strabismus. 2014; 1; 51(4): 230-4.
  23. Shields C.L., Mashayekhi A., Luo C.K., Materin M.A., Shields J.A. Optical coherence tomography in children: analysis of 44 eyes with intraocular tumors and simulating conditions. J. Pediatr. Ophthalmol. Strabismus. 2004; 41(6): 338-44.
  24. Rootman D.B., Gonzalez E., Mallipatna A., Vandenhoven C., Hampton L., Dimaras H., Chan H.S., Gallie B.L., Heon E. Hand-held high-resolution spectral domain optical coherence tomography in retinoblastoma: clinical and morphologic considerations. Br. J. Ophthalmol. 2013; 97(1): 59-65.
  25. Shields C.L., Douglass A.M., Beggache M., Say E.A.T., Shields J.A. Intravitreous chemotherapy for active vitreous seeding from retinoblastoma: Outcomes After 192 Consecutive Injections. The 2015 Howard Naquin Lecture. Retina. 2016; 36 (6): 1184-90. doi: 10.1097/IAE.0000000000000903
  26. Саакян С.В., Жаруа А.А., Мякошина Е.Б., Лазарева Л.А., Яковлев С.Б. Суперселективная интраартериальная химиотерапия в лечении резистентных и далекозашедших форм ретинобластомы: возможные осложнения и меры их профилактики. Российская педиатрическая офтальмология. 2013; 1: 31-4.
  27. Francis J.H., Schaiquevich P., Buitrago E., Del Sole M.J., Zapata G., Croxatto J.O., Marr B.P., Brodie S.E., Berra A., Chantada G.L., Abramson D.H. Local and systemic toxicity of intravitreal melphalan for vitreous seeding in retinoblastoma: a preclinical and clinical study. Ophthalmology. 2014 Sep; 121(9): 1810-7. doi: 10.1016/j.ophtha.2014.03.028.

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