RESUMEN
Importance: Globe salvage marks the treatment success of retinoblastoma. Background: To evaluate four treatment strategies in group D and group E retinoblastoma. Design: Retrospective case series in a tertiary hospital. Participants: 81 patients with Group D and Group E retinoblastoma. Methods: Participants were divided into four sets. In set I, eyes received primary intravenous chemotherapy (IVC), cryotherapy (CT), laser therapy (LT) and Intravitreal Chemotherapy with Melphalan (IViC). In set II, primary IVC was combined with second line IVC, CT, LT and IVT-M. Set III eyes received primary IVC and Intra-arterial chemotherapy (IAC), CT, LT and IViC. Set IV eyes received IAC, CT, LT and IViC. Treatment failure was defined as inadequate response during or after IVC or IAC. Main Outcome Measures: globe salvage and enucleation rates. Results: 52 eyes were included in group D and 29 in group E. In group D, globe salvage was obtained in 8 out of 11 eyes in Set I, 13 out of 19 eyes in set II, 5 out 6 eyes in set III, and 13 out of 16 eyes in set IV. In group E, enucleation was performed in 17 eyes. Global salvage was obtained in 0 out of 2 eyes in set I, 2 out of 3 eyes in set II, 3 out of 5 in set III, and in 1 out of 2 eyes in set IV. Conclusions: IVC with adjuvant IAC, LT, CT and IViC has shown favorable results as a treatment method for group D and group E retinoblastoma.
Asunto(s)
Crioterapia/métodos , Enucleación del Ojo/métodos , Melfalán/administración & dosificación , Estadificación de Neoplasias , Neoplasias de la Retina/terapia , Retinoblastoma/terapia , Terapia Recuperativa/métodos , Adulto , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Infusiones Intravenosas , Masculino , Agonistas Mieloablativos/administración & dosificación , Neoplasias de la Retina/diagnóstico , Retinoblastoma/diagnóstico , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Blunt trauma may cause a wound in the site of the cataract incision in patients that have received this surgery, even decades after the procedure. The opening of the incision seems to avoid globe rupture, acting as a "liberating valve" We report a case of a 92-year-old woman with advanced dry macular degeneration who is referred to our department after suffering a blunt trauma in her left eye with a nightstand. She was diagnosed of a traumatic total iridectomy due to iris extrusion through a 2.75 mm cataract incision after injury and vitreous hemorrhage, sparing an intact intraocular lens and capsular bag, as well as peripheral remnants of cortical material in the capsular bag and anterior capsule opacity resembling "pseudoiris". After the vitreous hemorrhage was completely resolved she referred no photophobia. Consequently, although a bad visual acuity of the patient could mitigate patient's photophobia, we believed that her "pseudoiris" plays an important role in diminishing the possible symptoms of photophobia.
