1) Retinoblastoma is a rare cancer that arises from retinal cells in one or both eyes. It is the most common eye cancer in children.
2) Diagnosis is based on examination findings including a white pupil reflex. Imaging such as ultrasound, CT, and MRI are used to determine extent.
3) Treatment depends on disease extent and aim to preserve vision if possible. Local therapies for small tumors include cryotherapy, laser, and plaque radiation. Enucleation or exenteration are used for more advanced intraocular disease. Chemotherapy and external beam radiation are given for extraocular spread.
This document provides information on retinoblastoma, including its history, epidemiology, genetics, clinical manifestations, diagnosis, staging, prognosis, and management. Some key points:
- Retinoblastoma is a malignant tumor of the retina that typically presents in childhood. It can be hereditary or sporadic.
- Presenting signs may include leukocoria, strabismus, reduced vision. Advanced cases can involve the optic nerve or orbit.
- Diagnosis involves examinations like ultrasonography, MRI, and indirect ophthalmoscopy. Genetic testing helps determine hereditary risk.
- Staging considers tumor size, location, laterality and extent. Prognostic factors include age and
- Retinoblastoma is a rare cancer that affects the retina in young children. It arises from primitive retinal cells.
- The patient was a 19 month old boy referred for a white pupil in the right eye noticed for 4 months. Examination found a white pupil and squint in the right eye.
- Investigations including ultrasound and MRI confirmed the diagnosis of retinoblastoma in the right eye. The family then took the child to another hospital for further chemotherapy and management.
Marfan Syndrome is a genetic disorder of connective tissue caused by mutations in the FBN1 gene resulting in skeletal, ocular, and cardiovascular abnormalities. It is characterized by disproportionately long limbs, joint hypermobility, eye problems like ectopia lentis, and life-threatening issues like aortic aneurysm. Diagnosis is based on clinical assessment using systemic criteria. Management focuses on surveillance and prevention of complications through beta-blockers, surgery, and potentially losartan which may help slow aortic root growth. Prognosis has improved with current treatments but cardiovascular events remain common.
The document discusses various types of orbital and ocular tumors. It describes:
1. Capillary haemangioma, the most common orbital tumor in children, affecting girls more commonly.
2. Cavernous haemangioma, the most common benign orbital tumor in adults, presenting in the 4th-5th decade with progressive proptosis.
3. Pleomorphic lacrimal gland adenoma, the most common epithelial tumor of the lacrimal gland, presenting in the 2nd-5th decade with painless proptosis or swelling.
Retinoblastoma is a rare cancer that affects the retina. It is the most common eye cancer in children and its incidence ranges from 1 in 14,000 to 1 in 34,000 live births worldwide. The document discusses the epidemiology, genetics, pathology, clinical presentation, diagnostic evaluation, classification systems, management options including chemotherapy, radiation therapy, cryotherapy and enucleation, and importance of genetic counseling for families with retinoblastoma.
Neurofibromatosis cannot be prevented. People with a family history of the disease may choose to undergo genetic testing and counseling to determine if they are at risk for transmitting NF to their offspring.
The document discusses various types of orbital tumours and pathologies. It describes three main intraorbital spaces - intraconal, conal and extraconal - and examples of pathologies that can occur in each space. It provides details on orbital lymphoma, rhabdomyosarcoma, orbital metastasis and dermoid cysts. For each condition, it outlines clinical features, location in the orbit, radiological features on CT and MRI such as signal characteristics, enhancement patterns and appearance. Common primary cancers that metastasize to the orbit are also listed.
This document provides information on retinoblastoma, including its history, epidemiology, genetics, clinical manifestations, diagnosis, staging, prognosis, and management. Some key points:
- Retinoblastoma is a malignant tumor of the retina that typically presents in childhood. It can be hereditary or sporadic.
- Presenting signs may include leukocoria, strabismus, reduced vision. Advanced cases can involve the optic nerve or orbit.
- Diagnosis involves examinations like ultrasonography, MRI, and indirect ophthalmoscopy. Genetic testing helps determine hereditary risk.
- Staging considers tumor size, location, laterality and extent. Prognostic factors include age and
- Retinoblastoma is a rare cancer that affects the retina in young children. It arises from primitive retinal cells.
- The patient was a 19 month old boy referred for a white pupil in the right eye noticed for 4 months. Examination found a white pupil and squint in the right eye.
- Investigations including ultrasound and MRI confirmed the diagnosis of retinoblastoma in the right eye. The family then took the child to another hospital for further chemotherapy and management.
Marfan Syndrome is a genetic disorder of connective tissue caused by mutations in the FBN1 gene resulting in skeletal, ocular, and cardiovascular abnormalities. It is characterized by disproportionately long limbs, joint hypermobility, eye problems like ectopia lentis, and life-threatening issues like aortic aneurysm. Diagnosis is based on clinical assessment using systemic criteria. Management focuses on surveillance and prevention of complications through beta-blockers, surgery, and potentially losartan which may help slow aortic root growth. Prognosis has improved with current treatments but cardiovascular events remain common.
The document discusses various types of orbital and ocular tumors. It describes:
1. Capillary haemangioma, the most common orbital tumor in children, affecting girls more commonly.
2. Cavernous haemangioma, the most common benign orbital tumor in adults, presenting in the 4th-5th decade with progressive proptosis.
3. Pleomorphic lacrimal gland adenoma, the most common epithelial tumor of the lacrimal gland, presenting in the 2nd-5th decade with painless proptosis or swelling.
Retinoblastoma is a rare cancer that affects the retina. It is the most common eye cancer in children and its incidence ranges from 1 in 14,000 to 1 in 34,000 live births worldwide. The document discusses the epidemiology, genetics, pathology, clinical presentation, diagnostic evaluation, classification systems, management options including chemotherapy, radiation therapy, cryotherapy and enucleation, and importance of genetic counseling for families with retinoblastoma.
Neurofibromatosis cannot be prevented. People with a family history of the disease may choose to undergo genetic testing and counseling to determine if they are at risk for transmitting NF to their offspring.
The document discusses various types of orbital tumours and pathologies. It describes three main intraorbital spaces - intraconal, conal and extraconal - and examples of pathologies that can occur in each space. It provides details on orbital lymphoma, rhabdomyosarcoma, orbital metastasis and dermoid cysts. For each condition, it outlines clinical features, location in the orbit, radiological features on CT and MRI such as signal characteristics, enhancement patterns and appearance. Common primary cancers that metastasize to the orbit are also listed.
Retinitis pigmentosa is a group of inherited retinal diseases characterized by progressive degeneration of the photoreceptors. It initially affects rods, resulting in night blindness and peripheral vision loss, and later involves cones leading to tunnel vision. Symptoms include nyctalopia and peripheral field defects. Signs include bone spicule pigmentation, arteriolar attenuation, and disc pallor. It can be inherited in autosomal dominant, recessive or X-linked patterns. Investigations include electroretinography to detect photoreceptor dysfunction and optical coherence tomography. There is currently no cure or treatment to stop progression.
- Proptosis refers to forward displacement of the eyeball beyond the orbital rim, usually due to an increased mass or volume within the orbit. Common causes include tumors, inflammation, trauma, thyroid eye disease, and vascular lesions.
- Examination involves measuring exophthalmometry, inspecting for signs of mass effect, pulsation or displacement of the globe, and evaluating for neurologic deficits. Imaging with CT or MRI is important to characterize the lesion causing proptosis.
This document discusses several phakomatoses or neurocutaneous syndromes characterized by hamartomas of the skin, eye, central nervous system and other organs. It provides details on the clinical features, genetics, systemic and ophthalmic manifestations as well as management of specific conditions like Neurofibromatosis types 1 and 2, Von Hippel-Lindau disease, Tuberous sclerosis, Sturge-Weber syndrome, and Ataxia telangiectasia. Key aspects like characteristic tumors, genetic mutations, diagnostic criteria and treatment approaches are highlighted for each discussed syndrome.
This document provides information on the clinical evaluation, imaging, classification, staging, management, and molecular therapy approaches for retinoblastoma. It discusses various treatment options including chemotherapy, surgery, radiation therapy, and newer targeted molecular therapies. Current treatment protocols are outlined based on the classification and staging of the retinoblastoma.
The document defines phakomatoses as multisystem disorders involving the central nervous system, eyes, and skin that cause characteristic lesions and hamartomas. It then describes several common and uncommon phakomatoses syndromes in detail, focusing on their defining clinical features, inheritance patterns, prevalence, and ocular manifestations. The most prominent syndromes discussed are neurofibromatosis types 1 and 2, tuberous sclerosis, Von Hippel-Lindau disease, Sturge-Weber syndrome, and Wyburn-Mason syndrome.
Retinitis pigmentosa is a genetic disorder that causes the rods and cones in the retina to deteriorate over time. This leads to progressive vision loss starting with night blindness and loss of peripheral vision, which can eventually cause total blindness. There is no cure, but vitamin A supplementation and an omega-3 rich diet have been shown to potentially slow the progression of the disease. It is diagnosed through visual field tests and ERG testing, and patients are referred to low vision specialists who can prescribe aids to help maximize remaining vision.
Marfan syndrome is an autosomal dominant genetic disorder of connective tissue that affects many parts of the body including the heart, blood vessels, bones, lungs and eyes. It is caused by mutations in the FBN1 gene which results in abnormal production of fibrillin-1, an important component of connective tissue. Common features include tall stature, long limbs, curved spine and eye problems. Treatment focuses on managing cardiovascular complications through beta blockers and surgery as well as correcting skeletal abnormalities. Current research aims to better understand the genetic basis of Marfan syndrome and related disorders to improve diagnosis and treatment.
Thyroid eye disease (TED), also known as Graves' orbitopathy, is a self-limiting autoimmune condition that affects the eye muscles and fatty tissues behind the eyes. It is commonly associated with Graves' disease and hyperthyroidism. Treatment depends on the severity and includes corticosteroids to reduce inflammation, radiation therapy, orbital decompression surgery, and eyelid or muscle surgery to correct motility disorders or abnormalities. While TED has no cure currently, treatment aims to manage active inflammation and correct residual issues once the disease becomes inactive.
Age-related macular degeneration (AMD) is a common cause of vision loss in older adults. There are two main types: dry AMD, characterized by drusen and retinal pigment abnormalities, and wet AMD, characterized by abnormal blood vessel growth. Risk factors include increasing age, smoking, family history, and genetics. Diagnosis involves examination of the retina and macula using techniques like funduscopy, fluorescein angiography, and optical coherence tomography. Treatment options for wet AMD aim to stop blood vessel growth through therapies like anti-VEGF injections, photodynamic therapy, and laser photocoagulation. Lifestyle modifications and antioxidant supplements may help reduce risk of progression for dry AMD.
Marfan syndrome is a genetic disorder that affects connective tissue in the body. It is caused by a mutation in the gene that controls production of fibrillin, a protein important for connective tissue. Symptoms vary but often involve unusually long limbs, fingers and toes as well as health issues like vision problems, heart problems, and collapsed lungs. Treatment focuses on managing heart, eye and lung issues through medication, surgery and lifestyle changes like exercise and not smoking. Regular screening is important to monitor health and catch any problems early.
Retinoblastoma (RB) is a rare form of cancer, that rapidly develops from the immature cells of a retina ( the light-detecting tissue of the eye). It is the most common primary malignant intraocular cancer in children.
Cancer of the Eye
Diagnosis: Birth-~6 years olds
Unilateral or Bilateral
~3% of Pediatric Cancers
Retinoblastoma is a cancer of the retina. The eye has three layers - an outer fibrous layer, inner sensory retina, and middle vascular layer. Retinoblastoma appears as opaque, yellow-white tumors in the retina seen on fundus examination. Diagnosis is confirmed through imaging like CT/MRI showing enhancement and retinal detachment. Treatment involves radiation therapy using plaques or external beam, with doses of 40-45Gy over 5 days to treat the whole retina while sparing other tissues. Follow up is needed every 4-6 weeks initially and yearly long term to monitor for recurrence.
Age-related macular degeneration is a progressive degeneration of the macula that occurs in elderly patients. It is characterized by the formation of drusen, geographic atrophy of the retinal pigment epithelium, and choroidal neovascularization. Risk factors include increasing age, family history, and light exposure. Late stage AMD can be either dry, characterized by drusen and macular thinning, or wet, characterized by neovascularization, bleeding, and leakage of fluid. Treatment options for wet AMD include laser photocoagulation, photodynamic therapy, and injections of anti-VEGF drugs.
This is a beginner's guide to retinoblastoma. I have briefly covered all the aspects of this most common intraocular tumor of childhood. Hope it will help the undergraduate medical students. Please check out our blog, http://pgblaster.wordpress.com for more presentations and useful stuffs like this one.
Laser photocoagulation is used to destroy small tumors by burning them with a laser beam. It is used for very small tumors away from important eye structures like the macula and optic disc. Side effects can include retinal edema and detachment.
This document discusses the management of retinoblastoma. It describes various staging and classification systems used, including the original Reese-Ellsworth system from 1964 and the updated International Classification from 2006. It then outlines different treatment modalities for retinoblastoma, including focal therapies like cryotherapy, laser treatments, and radioactive plaque applications. It also discusses external beam radiotherapy techniques like lateral beam and direct anterior field approaches. The goal of treatment is to save the patient's life while preserving useful vision if possible.
The document summarizes various tumors that can occur on the eyelid. It divides tumors into benign, pre-malignant, and malignant categories and lists examples of tumors that fall into each category. Some of the more common tumor types discussed include squamous cell papilloma, basal cell carcinoma, sebaceous gland adenoma and carcinoma, capillary hemangioma, and non-Hodgkin lymphoma. For each tumor, the summary provides details on clinical presentation and recommended treatment approaches.
The document summarizes malignant intraocular tumors, focusing on retinoblastoma. It discusses retinoblastoma genetics, clinical features, diagnosis, staging, and treatment. Retinoblastoma is the most common intraocular malignancy in children, caused by deletion of the RB1 tumor suppressor gene. Clinical features include leukocoria. Diagnosis involves ophthalmic examination, imaging like CT/MRI, and histopathology showing Flexner-Wintersteiner rosettes. Staging systems include Reese-Ellsworth and the International Classification. Treatment depends on staging and includes focal therapies, chemotherapy, radiation, and enucleation. The goal is survival while retaining eyes and vision when possible
Dr. Renesha Islam and Dr. Farzana Alam Mou presented on retinoblastoma. The presentation included an overview of retinoblastoma including its: anatomy and histology; classification based on laterality, focality, heredity, family history and growth pattern; genetics involving mutations in the RB1 gene; clinical presentations; investigations including examination under anesthesia and imaging; treatment options; and prognosis. Retinoblastoma is a malignant tumor of the retina that predominantly affects young children.
Lagophthalmos describes incomplete eyelid closure which puts the cornea at risk. It is often caused by facial nerve paralysis. Evaluation involves measuring the eyelid gap and examining for signs of exposure keratopathy. Treatment aims to protect the cornea and may include artificial tears, taping, and surgery like tarsorrhaphy or gold weight implantation depending on severity. Prognosis depends on the underlying cause but uncontrolled lagophthalmos can lead to vision threatening complications.
Retinoblastoma - Diagnosis and Management Presentationdocumesh
This document provides an overview of retinoblastoma, a rare eye cancer that affects children. It discusses the following key points:
- Retinoblastoma is the most common eye cancer in children. It is caused by mutations in the RB1 tumor suppressor gene.
- Presenting symptoms often include leukocoria (white pupil reflex) or strabismus. Diagnosis is usually made through ultrasound, MRI, CT scan, or histopathology.
- Treatment depends on factors like tumor stage and genetics. Options include focal therapies like cryotherapy or thermotherapy, external beam radiation, chemotherapy, and enucleation. The goal is usually tumor control while preserving vision and the eye.
Retinoblastoma is a type of eye tumor which can run in families. This ppt explains different types of Retinoblastomas , their treatments and possible outcomes. This can be a useful guide in eye research.
Retinitis pigmentosa is a group of inherited retinal diseases characterized by progressive degeneration of the photoreceptors. It initially affects rods, resulting in night blindness and peripheral vision loss, and later involves cones leading to tunnel vision. Symptoms include nyctalopia and peripheral field defects. Signs include bone spicule pigmentation, arteriolar attenuation, and disc pallor. It can be inherited in autosomal dominant, recessive or X-linked patterns. Investigations include electroretinography to detect photoreceptor dysfunction and optical coherence tomography. There is currently no cure or treatment to stop progression.
- Proptosis refers to forward displacement of the eyeball beyond the orbital rim, usually due to an increased mass or volume within the orbit. Common causes include tumors, inflammation, trauma, thyroid eye disease, and vascular lesions.
- Examination involves measuring exophthalmometry, inspecting for signs of mass effect, pulsation or displacement of the globe, and evaluating for neurologic deficits. Imaging with CT or MRI is important to characterize the lesion causing proptosis.
This document discusses several phakomatoses or neurocutaneous syndromes characterized by hamartomas of the skin, eye, central nervous system and other organs. It provides details on the clinical features, genetics, systemic and ophthalmic manifestations as well as management of specific conditions like Neurofibromatosis types 1 and 2, Von Hippel-Lindau disease, Tuberous sclerosis, Sturge-Weber syndrome, and Ataxia telangiectasia. Key aspects like characteristic tumors, genetic mutations, diagnostic criteria and treatment approaches are highlighted for each discussed syndrome.
This document provides information on the clinical evaluation, imaging, classification, staging, management, and molecular therapy approaches for retinoblastoma. It discusses various treatment options including chemotherapy, surgery, radiation therapy, and newer targeted molecular therapies. Current treatment protocols are outlined based on the classification and staging of the retinoblastoma.
The document defines phakomatoses as multisystem disorders involving the central nervous system, eyes, and skin that cause characteristic lesions and hamartomas. It then describes several common and uncommon phakomatoses syndromes in detail, focusing on their defining clinical features, inheritance patterns, prevalence, and ocular manifestations. The most prominent syndromes discussed are neurofibromatosis types 1 and 2, tuberous sclerosis, Von Hippel-Lindau disease, Sturge-Weber syndrome, and Wyburn-Mason syndrome.
Retinitis pigmentosa is a genetic disorder that causes the rods and cones in the retina to deteriorate over time. This leads to progressive vision loss starting with night blindness and loss of peripheral vision, which can eventually cause total blindness. There is no cure, but vitamin A supplementation and an omega-3 rich diet have been shown to potentially slow the progression of the disease. It is diagnosed through visual field tests and ERG testing, and patients are referred to low vision specialists who can prescribe aids to help maximize remaining vision.
Marfan syndrome is an autosomal dominant genetic disorder of connective tissue that affects many parts of the body including the heart, blood vessels, bones, lungs and eyes. It is caused by mutations in the FBN1 gene which results in abnormal production of fibrillin-1, an important component of connective tissue. Common features include tall stature, long limbs, curved spine and eye problems. Treatment focuses on managing cardiovascular complications through beta blockers and surgery as well as correcting skeletal abnormalities. Current research aims to better understand the genetic basis of Marfan syndrome and related disorders to improve diagnosis and treatment.
Thyroid eye disease (TED), also known as Graves' orbitopathy, is a self-limiting autoimmune condition that affects the eye muscles and fatty tissues behind the eyes. It is commonly associated with Graves' disease and hyperthyroidism. Treatment depends on the severity and includes corticosteroids to reduce inflammation, radiation therapy, orbital decompression surgery, and eyelid or muscle surgery to correct motility disorders or abnormalities. While TED has no cure currently, treatment aims to manage active inflammation and correct residual issues once the disease becomes inactive.
Age-related macular degeneration (AMD) is a common cause of vision loss in older adults. There are two main types: dry AMD, characterized by drusen and retinal pigment abnormalities, and wet AMD, characterized by abnormal blood vessel growth. Risk factors include increasing age, smoking, family history, and genetics. Diagnosis involves examination of the retina and macula using techniques like funduscopy, fluorescein angiography, and optical coherence tomography. Treatment options for wet AMD aim to stop blood vessel growth through therapies like anti-VEGF injections, photodynamic therapy, and laser photocoagulation. Lifestyle modifications and antioxidant supplements may help reduce risk of progression for dry AMD.
Marfan syndrome is a genetic disorder that affects connective tissue in the body. It is caused by a mutation in the gene that controls production of fibrillin, a protein important for connective tissue. Symptoms vary but often involve unusually long limbs, fingers and toes as well as health issues like vision problems, heart problems, and collapsed lungs. Treatment focuses on managing heart, eye and lung issues through medication, surgery and lifestyle changes like exercise and not smoking. Regular screening is important to monitor health and catch any problems early.
Retinoblastoma (RB) is a rare form of cancer, that rapidly develops from the immature cells of a retina ( the light-detecting tissue of the eye). It is the most common primary malignant intraocular cancer in children.
Cancer of the Eye
Diagnosis: Birth-~6 years olds
Unilateral or Bilateral
~3% of Pediatric Cancers
Retinoblastoma is a cancer of the retina. The eye has three layers - an outer fibrous layer, inner sensory retina, and middle vascular layer. Retinoblastoma appears as opaque, yellow-white tumors in the retina seen on fundus examination. Diagnosis is confirmed through imaging like CT/MRI showing enhancement and retinal detachment. Treatment involves radiation therapy using plaques or external beam, with doses of 40-45Gy over 5 days to treat the whole retina while sparing other tissues. Follow up is needed every 4-6 weeks initially and yearly long term to monitor for recurrence.
Age-related macular degeneration is a progressive degeneration of the macula that occurs in elderly patients. It is characterized by the formation of drusen, geographic atrophy of the retinal pigment epithelium, and choroidal neovascularization. Risk factors include increasing age, family history, and light exposure. Late stage AMD can be either dry, characterized by drusen and macular thinning, or wet, characterized by neovascularization, bleeding, and leakage of fluid. Treatment options for wet AMD include laser photocoagulation, photodynamic therapy, and injections of anti-VEGF drugs.
This is a beginner's guide to retinoblastoma. I have briefly covered all the aspects of this most common intraocular tumor of childhood. Hope it will help the undergraduate medical students. Please check out our blog, http://pgblaster.wordpress.com for more presentations and useful stuffs like this one.
Laser photocoagulation is used to destroy small tumors by burning them with a laser beam. It is used for very small tumors away from important eye structures like the macula and optic disc. Side effects can include retinal edema and detachment.
This document discusses the management of retinoblastoma. It describes various staging and classification systems used, including the original Reese-Ellsworth system from 1964 and the updated International Classification from 2006. It then outlines different treatment modalities for retinoblastoma, including focal therapies like cryotherapy, laser treatments, and radioactive plaque applications. It also discusses external beam radiotherapy techniques like lateral beam and direct anterior field approaches. The goal of treatment is to save the patient's life while preserving useful vision if possible.
The document summarizes various tumors that can occur on the eyelid. It divides tumors into benign, pre-malignant, and malignant categories and lists examples of tumors that fall into each category. Some of the more common tumor types discussed include squamous cell papilloma, basal cell carcinoma, sebaceous gland adenoma and carcinoma, capillary hemangioma, and non-Hodgkin lymphoma. For each tumor, the summary provides details on clinical presentation and recommended treatment approaches.
The document summarizes malignant intraocular tumors, focusing on retinoblastoma. It discusses retinoblastoma genetics, clinical features, diagnosis, staging, and treatment. Retinoblastoma is the most common intraocular malignancy in children, caused by deletion of the RB1 tumor suppressor gene. Clinical features include leukocoria. Diagnosis involves ophthalmic examination, imaging like CT/MRI, and histopathology showing Flexner-Wintersteiner rosettes. Staging systems include Reese-Ellsworth and the International Classification. Treatment depends on staging and includes focal therapies, chemotherapy, radiation, and enucleation. The goal is survival while retaining eyes and vision when possible
Dr. Renesha Islam and Dr. Farzana Alam Mou presented on retinoblastoma. The presentation included an overview of retinoblastoma including its: anatomy and histology; classification based on laterality, focality, heredity, family history and growth pattern; genetics involving mutations in the RB1 gene; clinical presentations; investigations including examination under anesthesia and imaging; treatment options; and prognosis. Retinoblastoma is a malignant tumor of the retina that predominantly affects young children.
Lagophthalmos describes incomplete eyelid closure which puts the cornea at risk. It is often caused by facial nerve paralysis. Evaluation involves measuring the eyelid gap and examining for signs of exposure keratopathy. Treatment aims to protect the cornea and may include artificial tears, taping, and surgery like tarsorrhaphy or gold weight implantation depending on severity. Prognosis depends on the underlying cause but uncontrolled lagophthalmos can lead to vision threatening complications.
Retinoblastoma - Diagnosis and Management Presentationdocumesh
This document provides an overview of retinoblastoma, a rare eye cancer that affects children. It discusses the following key points:
- Retinoblastoma is the most common eye cancer in children. It is caused by mutations in the RB1 tumor suppressor gene.
- Presenting symptoms often include leukocoria (white pupil reflex) or strabismus. Diagnosis is usually made through ultrasound, MRI, CT scan, or histopathology.
- Treatment depends on factors like tumor stage and genetics. Options include focal therapies like cryotherapy or thermotherapy, external beam radiation, chemotherapy, and enucleation. The goal is usually tumor control while preserving vision and the eye.
Retinoblastoma is a type of eye tumor which can run in families. This ppt explains different types of Retinoblastomas , their treatments and possible outcomes. This can be a useful guide in eye research.
Retinoblastoma is a rare eye cancer that affects children. It is caused by mutations in the RB1 tumor suppressor gene. There are two main types - sporadic which occurs spontaneously, and hereditary which is inherited. Treatment depends on tumor size and extent, and may include chemotherapy, laser therapy, cryotherapy, plaque brachytherapy, or enucleation of the eye for large tumors. The goal is to save vision if possible or life if the eye cannot be saved. Screening of family members is important given the hereditary risk.
The retina is the innermost layer of the eye that contains photoreceptor cells. Retinoblastoma is a malignant tumor that arises from these photoreceptor cells in the retina, most commonly affecting young children under 5 years old. It can be hereditary if caused by a mutation in the RB1 gene, resulting in bilateral and multifocal tumors, or non-hereditary if caused by somatic mutations, usually presenting as a unilateral tumor. Treatment depends on tumor size and extent but may include chemotherapy, local therapies like cryotherapy or brachytherapy, and enucleation of the eye for advanced cases. Early diagnosis and treatment can help preserve vision and life.
Case Presentation Abdur Rehman Ilyas Ratinoblastoma.pptxAbdur Rehman
This document presents a case study of a 4-year-old female patient who presented with decreased vision in her right eye. Examination revealed leukocoria in the right eye. Differential diagnoses included retinoblastoma, which was suspected due to the presence of calcification on B-scan. Investigations including CT and MRI confirmed the diagnosis of retinoblastoma. Treatment options for retinoblastoma aim to save the patient's life and vision, and may include focal therapies like cryotherapy, brachytherapy, or chemotherapy depending on the classification and extent of the tumor. The prognosis is generally good if the tumor is caught early and treated appropriately.
Retinoblastoma is a rare childhood cancer that develops from immature retinal cells. It is caused by mutations in the RB1 tumor suppressor gene. The presentation may include leukocoria, strabismus, or pain. Diagnosis is usually made through ophthalmic examination and imaging like ultrasound, CT, or MRI. Treatment is multidisciplinary and aims to cure the disease while preserving the eye and vision if possible. Modalities include enucleation, cryotherapy, laser therapy, brachytherapy, chemotherapy, and external beam radiotherapy. The prognosis is generally good if caught early, with a focus on a coordinated, individualized treatment approach for each case.
Intraocular tumours can arise from the uveal tract (choroid, ciliary body, iris), retina, or optic nerves. Tumours of the uveal tract include benign lesions like naevi, hemangiomas, and melanocytomas, as well as malignant melanomas. Retinal tumours include neuroblastic tumours and angiomata. The most common intraocular tumour is malignant melanoma of the choroid, which presents as an orange pigmented lesion and can lead to vision loss, glaucoma, or extraocular spread. Retinoblastoma is the most common eye tumour in children and appears as a white pupillary reflex or squint. It is diagnosed by examination under anesthesia
Retinoblastoma is known to be a rare eye cancer, which occurs from the immature retina cells. It is one of the most common malignant cancer found in young children.
This document provides an overview of retinoblastoma, including:
1. A brief history of retinoblastoma classification and descriptions.
2. Details on the genetics and pathogenesis of retinoblastoma, including the two-hit hypothesis.
3. Presenting features, diagnostic testing, classification systems, and treatment options for retinoblastoma such as chemotherapy, radiation therapy, cryotherapy, and enucleation.
Retinoblastoma for undergraduate MBBS Students.
Covers the basics of Aetiology, Genetics, pathophysiology, clinical features, Classification and management of Retinoblastoma.
Also encompasses salient points for PGMEE
This document summarizes various orbital tumors and vascular lesions. It discusses their epidemiology, clinical presentation, diagnostic evaluation including imaging findings and histopathology, complications, and treatment approaches. A wide variety of benign and malignant tumors are covered, from infantile hemangiomas to lymphangiomas to orbital varices. Diagnosis involves a combination of history, exam, imaging modalities like CT and MRI, and sometimes biopsy. Management depends on factors like location, size, symptoms, and includes observation, medications, surgery, radiation, and rarely exenteration.
Orbital tumors can be primary, secondary, or metastatic in origin. The most common malignant orbital tumor in adults is lymphoma, which typically involves the lacrimal gland. Malignant melanoma of the uvea is also relatively common and can arise in the iris, ciliary body, or choroid. Treatment options depend on the type and size of the tumor but may include surgery, radiation therapy such as plaque brachytherapy, proton beam therapy, or stereotactic radiotherapy. Complications can include vision loss, glaucoma, and cataracts.
[1] Ocular Surface Squamous Neoplasia (OSSN) refers to a spectrum of dysplastic and malignant squamous lesions of the conjunctiva and cornea.
[2] Diagnosis is usually clinical but can be confirmed with biopsy. For suspected OSSN less than 3 clock hours, excision biopsy with cryotherapy and alcohol epitheliectomy is performed. Larger lesions may require chemoreduction with topical chemotherapy prior to surgery and cryotherapy.
[3] Risk factors include ultraviolet light, HIV, and human papillomavirus. While rare, metastasis can occur to local lymph nodes or distant sites like lungs. Recurrence after treatment ranges from 15-52% depending
Retinoblastoma is a rare cancer that affects the retina. It is caused by mutations in the RB1 gene. There are two main types - hereditary retinoblastoma, which requires only one mutation, and sporadic retinoblastoma, which requires two mutations. Symptoms include leukocoria. Diagnosis involves ophthalmoscopy, imaging like ultrasound and MRI, and sometimes biopsy. Treatment depends on factors like tumor size and location, and may include focal therapies like cryotherapy, chemotherapy, external beam radiation, plaque brachytherapy, or enucleation of the eye. Prognosis depends on extent of disease and risk of metastasis.
Retinoblastoma is a rare cancer that affects the retina in children. It is caused by mutations in the RB1 gene that regulates cell growth. The disease can be hereditary or sporadic. Presenting symptoms include leukocoria, strabismus, and vision loss. Diagnosis is usually made through eye examination and imaging tests like ultrasound and MRI. Treatment depends on disease stage and extent, and may include enucleation, chemotherapy, radiation therapy, cryotherapy, or brachytherapy to preserve vision and the eye. Retinoblastoma can spread from the eye to other parts of the body if not treated properly. Early detection and treatment are important for good outcomes.
This document provides information about tumors of the eye. It discusses various types of benign and malignant tumors that can occur in different parts of the eye, including the orbit, lacrimal gland, eyelids, conjunctiva, uveal tract, and retina. For each tumor type, it describes the classification (benign vs malignant), common sites of occurrence, signs and symptoms, diagnostic evaluation, and treatment approaches. For example, it explains that choroidal melanoma is the most common primary malignant tumor of the uveal tract, often appearing initially as an asymptomatic elevated pigmented mass, and treatment may involve plaque radiotherapy, enucleation, or charged particle radiation depending on tumor characteristics and prognosis. The document aims to
Radiosensitivity and cell age in mitotic cycle .pptxKiran Ramakrishna
1) The document discusses cell cycle analysis techniques like autoradiography using tritium-labeled thymidine and bromodeoxyuridine staining to determine what phase of the cell cycle cells are in.
2) It describes how synchronizing cells through mitotic shake-off or hydroxyurea blocking allows studying the effects of radiation at different phases, finding sensitivity is highest in M and lowest in S phase.
3) Checkpoint genes can stop the cell cycle if DNA is damaged, preventing mitosis, and their absence leads to higher radiation and cancer risks. The oxygen effect is also less for denser ionizing radiations.
This document discusses various cancer susceptibility syndromes. It begins by defining cancer susceptibility and the genetic and epigenetic factors that influence it. It then discusses several key syndromes in more detail, focusing on the genes involved, inheritance patterns, clinical features, and cancer risks. These include retinoblastoma (RB1 gene), Lynch syndrome (DNA mismatch repair genes), hereditary breast-ovarian cancer (BRCA1/2), neurofibromatosis type 1 (NF1 gene), and familial adenomatous polyposis (APC gene). It also outlines other syndromes categorized by the genes' functions in genomic integrity, proliferation, translation regulation, and angiogenesis.
Leukemia are neoplastic disorders of the hematopoietic system characterized by aberrant or arrested differentiation. There are two main types - acute and chronic leukemias. Acute leukemias are further classified as myeloid or lymphoid based on the lineage of the malignant cells. Chromosomal abnormalities are detected in the majority of acute leukemia cases and correlate with specific disease subtypes and clinical outcomes. Treatment involves induction chemotherapy followed by consolidation therapy and stem cell transplantation for eligible patients, with cure rates varying based on disease risk factors.
Craniospinal irradiation involves treating the entire brain and spinal cord to prevent spread of certain cancers. It was pioneered in the 1950s for medulloblastoma and other tumors. The target area includes the brain, spinal cord down to S2 or S3. Planning challenges include immobilizing the large target area and minimizing dose inhomogeneity at field junctions. Techniques like prone positioning, double junction fields, and IMRT aim to deliver a uniform dose while sparing organs at risk.
This document discusses pain management in cancer patients. It defines pain and describes the different types of pain. It discusses the pathophysiology of pain pathways and various scales used to assess and grade a patient's pain. It also discusses barriers to effective pain management and the WHO analgesic ladder for treating cancer pain with non-opioid and opioid medications like paracetamol, NSAIDs, tramadol, morphine, fentanyl, and methadone. Adjuvant therapies and alternative treatments are also mentioned.
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2. Clinical Anatomy
The eye is composed of three
layers.
Outer fibrous layer formed by
the sclera posteriorly and the
cornea anteriorly.
Inner layer , sensory retina with
vision concentrated at the fovea
which is lateral to the optic
nerve and directly posterior to
the lens.
In between these vascular layer –
the uvea or choroid –which
supplies the retina. The iris is
the outer continuation of the
vascular layer
Lens sits just behind iris,
suspended from the ciliary body.
No lymphatic drainage
3. Retinoblastoma
Mid 18th century: 1st clinical report of RB was recognized
1920-“ Vernoff” coined the term retinoblastoma
2.5-4% of paediatric malignancies
Most common intraocular malignancy of childhood
2nd most common primary intraocular malignancy in any age group
Tumor is of neuroepithelial origin & arises from unidentified
progenitor cell in nucleated layers of one or both eyes
Accounts for 1:17,000-34,000 live births worldwide
4. Epidemiology
Slight male preponderance 1.15:1.0
More than 90% of cases occur before age of 5 year
Most common among blacks & Africans
Age: average age in hereditary cases: 12-14 months, sporadic cases 24-30
months
Unilateral: 65-80%
Bilateral: 20-35%
Aetiology: unknown
5.
6. Genetics
Deletion of long arm of chromosome 13, 13q14, which is a tumor
suppressor gene termed as RB gene.
‘Alfred Knudson’ hypothesis: 2 types
Hereditary Non-hereditary
Familial Sporadic
Germline mutations 2 hits
Bilateral, multifocal Unilateral, unifocal
Young age older age
8. Retinoblastoma Gene
Chromosome 13q
Encodes for the RB protein
Master regulator of a number of subordinate proteins
mediating cell replication
pRB interacts with E2F family of proteins and prevents
cells from entering the cell cycle
Hypophosph form binds with E2F
Hyperphosph form is inactive
9. Clinical features
Family history: 10%
Leukocoria (white pupillary reflex): 50% ,
commonest
Strabismus [esotropia]: 20%
Ocular inflammation: due to necrosis of tumor
or tumor cells may enter AC resembling
hyphema [pseudohypopyon]
Secondary glaucoma: angle-closure
Loss of vision
Proptosis: extra ocular invasion
Trilateral retinoblastoma; bil RB+
pineoblastoma
Distant metastases
10.
11.
12. Routes of spread
Local spread; anteriorly- seeding of vitreous & aqueous; posteriorly, sub
retinal space and choroids
May spread through optic nerve
Along the central retinal vessels: tumor cells pass through the lamina
cribrosa and enter subarachnoid space
Distant metastases: CNS, skull, bones, lymph nodes, spinal cord, bone
marrow
Orbital involvement
15. International Classification of Retinoblastoma
Group Features
A Small tumor: ≤3 mm
B Large tumor: >3 mm
Macular: ≤3 mm to foveola
Juxtapapillary: ≤1.5 mm to disc
Subretinal fluid: ≤3 mm from the margin
C Focal seeds
Subretinal seeds: ≤3 mm
Vitreous seeds: ≤3 mm
Both subretinal and vitreous seeds: ≤3 mm
D Diffused seeds
Subretinal seeds: >3 mm
Vitreous seeds: >3 mm
Both subretinal and vitreous seeds: >3 mm
E Extensive retinoblastoma occupying more than 50% or
neovascular glaucoma
or opaque media from hemorrhage in anterior chamber, vitreous or subretinal space
Invasion of postlaminar optic nerve, choroid (> 2mm), sclera, orbit, anterior chamber
16. AJCC Tumour Staging System for RB
T1/p1 <25% of retina
T2/pT2 >25 to 50% of retina
T3/Pt3 >50% of retina and/or intraocular beyond retina
T3a/pT3a >50% of retina and/or cells in vitreous
T3b Optic disk
pT3b Optic nerve up to lamina cribrosa
T3c Anterior chamber and/or uvea
pT3c Anterior chamber and/or uvea and/or intrascleral
T4/pT4 Extraocular
T4a Optic nerve
pT4a Beyond lamina cribrosa, not at resection line
T4b Other extraocular
pT4b Other extraocular and/or at resection line
N1/pN1 Regional
MI Distant metastases
17. St. Jude’s Tumor Staging System
Stage I: Tumor (unifocal or multifocal) confined to retina
a. Occupying one quadrant or less
b. Occupying two quadrants or less
c. Occupying more than 50% of retinal surface
Stage II: Tumor (unifocal or multifocal) confined to globe
a. With vitreous seeding
b. Extending to optic nerve head
c. Extending to choroid
d. Extending to choroid and optic nerve head
e. Extending to emissaries
Stage III: Extraocular extension of tumor
a. Extending beyond cut end of optic nerve (including subarachnoid extension)
b. Extending through sclera into orbital contents
c. Extending to choroid and beyond cut end of optic nerve (including subarachnoid extension)
d. Extending through sclera into orbital contents and beyond cut end of optic nerve (including subarachnoid extension)
Stage IV: Distant metastases
a. Extending through optic nerve to brain
b. Blood-borne metastases to soft tissue(s) and bone(s)
c. Bone marrow metastases
18. Diagnostic workup
Diagnosis of retinoblastoma is made without pathologic
confirmation and is based on a clinical examination.
Clinical history
Physical examination: EUA
Direct ophthalmoscopy: white reflex
Indirect ophthalmoscopy:
RB seen as projecting into vitreous, creamy white in color, neovascularisation seen on
surface, calcification gives cottage cheese appearance (glistening white)
RB diagnosed owing to vitreous hemorrhage, RD, severe inflammatory reaction
(A) A fundus photograph of an eye with
retinoblastoma
(B) The corresponding sketch of the disease in
the eye diagram.
19. Ophthalmic USG: Non-invasive, safe, repeatable, and immediately interpretable.
B-scan USG reveals a 2D cross-sectional view, confirms presence and the
relationship, the size and shape of the tumors. Orbital involvement, optic
nerve invasion can be seen, extrascleral extension, and calcification.
.
B-scan of an eye with retinoblastoma
20. CT scan, dense heterogenous lesion with hyper dense foci corresponding to
calcification.
for assessing extraocular extension and invasion of the optic nerve.
A computed tomography scan of a
large calcified retinoblastoma in the
right eye.
21. Instead, as part of an extent-of-disease work-up, MRI is routinely performed.
Involvement of the optic nerve, extraocular extension, and intracranial midline
neoplasm in trilateral retinoblastoma are best detected.
Used in differentiating retinoblastoma from simulating lesions.
MRI
22. Other tests
Anterior chamber para-centesis: to assay LDH. Elevated ratio of aqueous
LDH5/LDH1 iso-enzymes, elevated ratio of aqueous LDH/ serum LDH
Fluorescein angiography: tumor blush
CSF cytology
Bone marrow biopsy &aspiration
Bone scan
Lab tests: Hemogram, Blood chemistries, KFT, LFT
24. Homer Wright Rosettes
Clusters of cells surrounding a tangle of cytoplasmic
filaments without a lumen
Also seen in Neuroblastoma
25. Treatment of Retinoblastoma
Primary goal
to ensure the survival of children.
retention of eyes and vision.
Avoidance of side effects- second malignancies, facial bony
deformities, or other physical changes that can affect functional
well-being.
Treatment approaches are guided by the presence of
intraocular or extraocular disease.
5 yr. DFS > 90% for intraocular disease pts., but < 10% for
extra-ocular disease.
28. Enucleation
Procedure: removal of globe after severing the rectus muscles, optic nerve is cut
(10-20mm) near its exit from the socket
Indications:
Unilateral RB with blind eye
Bilateral RB with both eyes blind- bilateral enucleation
Uni/bilateral RB with glaucoma (rubeosis iridis) with visual loss
Local recurrence after conservative measures fail
bilateral retinoblastoma in which the previously mentioned conditions exist in only one
eye
a tumor present in the anterior chamber
retinoblastoma unresponsive to other forms of local therapy
cases with permanent vision loss in which intraocular tumor is suspected.
29. Exenteration
Procedure: removal of globe, extra ocular muscles, lids , nerves and orbital fat
Indications:
Extensive local tumor breaching the globe
Recurrence of tumor in socket after enucleation
30. Local therapies
Used for small tumors < 3 – 6 mm
Usually in patients with bi-lateral disease and
In combination with Chemo- Radiation.
31. Cryotherapy
Procedure: tumor is localized (by indirect ophthalmoscope), indented trans-
sclerally with nitrous oxide cryoprobe, freeze is applied (-80°c),
Indications:
Small tumor anterior to equator (4-7 mm in size)
Small recurrence or tumor persisting after radiotherapy
In conjunction with chemotherapy (may increase the intravitreal penetration
of carboplatin)
Side effects:
Can induce acute retinal edema
Accumulation of sub retinal fluid → retinal detachment
32. Photocoagulation
Procedure: obliteration of retinal vessels by creating retinal burn with laser beam
Indications:
Tumor ≤4.5mm at base and ≤2.5mm thick
Away from macula or disc
Small tumor recurrence after prior irradiation
Contraindication: vitreous seeding
Laser hyperthermia
Procedure: generated by Diode laser (810 nm) on continuous mode
Single spot 0.8-2 mm placed on center of tumor
Tumor is heated for 10-30 min per session. Central tumor temperature 460c and
decreases by 20c for each mm outside the temperature spot
33. Radioactive plaque application
Isotopes used: Co-60, Ir-192, I-125, 106Rh (ß
emitter)
Co-60: circular, crescentic to fit around optic
nerve
I-125: seeds glued within a carrier and gold shield,
circular or notched configuration
Procedure: 1st USG of eye done: for tumor
dimensions: maximum basal diameter, max
height → surgical exploration → applicators are
applied over sclera overlying the tumor → 1.5-2
mm margin on either side of basal diameter →
retention sutures → Rx → Re-exploration for
removal of plaques
34. Iodine 125 plaques
Indications:
Solitary lesion 2-16 mm
basal diameter
Unifocal lesions
Located greater than 3
mm from optic nerve or
fovea
Thickness <10 mm
Two lesions, small or
close enough to be
covered by one plaque
Local recurrence (small)
following radiotherapy
[EBRT]
35. Cont…
treatment volume covers the tumor + 2mm margin.
Dose
dose to the tumor apex is 40 Gy (while the base receives 100–200 Gy).
dose rate is 0.7–1.0 Gy/h, and ~2–4 days of treatment are required.
Advantages: high tumor control rates with preservation of vision
Procedure time is short.
High dose of radiation to area of interest.
Disadvantages: increased dose to orbital bone and to operator
Complications: vascular necrosis, hemorrhage, cataract formation,
optic neuritis
37. External beam radiotherapy
Indications
Multi-focal retinoblastoma
RB close to macula or optic nerve
Large tumor with vitreous seeding
Positioning
Proper immobilization is important
thermoplastic or Perspex shell with the
patient supine and the chin in a neutral
position
Treatment is done under anesthesia:
Ketamine
Energy: Co-60 or 4-6 MV photons
38. Technique
Lateral field technique
Started in 1930’s
D – shaped lateral field with anterior border
kept at bony orbit
Disadvantage: tumor recurrence at or near ora
serrata
Modified lateral beam technique
Two lateral opposed D-shaped fields are used
39. Direct anterior field [Hungerford et al ]
Whole eye is treated
Disadvantage:
Cataract formation
Dose exits through brain
Lacrimal gland irradiation-impaired tear production
Advantages:
Simple, easy to setup
Reproducible
Homogenously irradiates entire retina
Anterior lens sparing technique (ALD) [Abramson et al ]
Lateral D-shaped field: Day1-Day 4 by photons
Anterior electron beam field with central circular contact lens as lens shaped shield: on
Day 5
40. Unilateral disease:
one lateral field or
2 oblique portals [superior and inferior]
Bilateral disease:
parallel opposed lateral fields
The anterior beam edge is placed at the bony
canthus and the beam is angled 1.5 degrees
posteriorly if the contralateral eye remains in
place.
41. Dose
Ideal: 40-45 Gy, 1.8-2 Gy per fraction, 5 days a week
For large tumor /vitreous seeding: 48-50 Gy
Palliative radiotherapy:
Extra-ocular involvement: 20-25 Gy
Metastatic disease: CNS, bones: 5 Gy/1#, 15 Gy/3#
Unilateral : single lateral field
With anterior extension: anterior field + lateral field tilted 5-15° posteriorly
Bilateral disease: parallel opposed lateral fields
42. 3D conformal radiotherapy
technique
based on 3D CT scan planning
In unilateral RB, 4 non-coplanar fields are used.
fields are anterior oblique: superior, inferior, medial, and lateral.
0.5-cm bolus can be used.
entire retina should be treated, including 5 to 8 mm of the proximal optic
nerve.
critical structures such as the opposite eye, optic chiasm, pituitary gland,
brainstem, posteriormost upper teeth, and upper cervical spine.
the tumor volume is treated to the 98% or 95% line,with the aforementioned
organs and tissues receiving significantly less dose.
43. bilateral disease, six
noncoplanar fields are used:
two lateral opposing, and
two anterior oblique fields
to each eye following the
same criteria described
previously.
3D CT scan reconstruction image showing beam arrangement for unilateral RB : anterior medial and lateral fields
(A), anterior superior and inferior fields (B), sagittal view of composite isodose distribution (C), and axial
transverse view of isodose distribution (D)
44. Side effects of RT
Cataract formation: lens
Lacrimal gland: decreased tear film production
Vascular: retinal vasculitis → hemorrhage, and vitreous opacity
Bone & soft tissue: temporal bone hypoplasia, molar tooth abnormalities
Mid-facial hypoplasia: hypotelorism, enophthalmos, atrophy of temporalis
muscle, narrow and deep orbits, depressed nasion.
Second malignancies: overall incidence: 3-5%
Most common are osteosarcoma, fibrosarcoma, other spindle cell sarcomas
46. “Chemoreduction” (using chemotherapy to reduce the size of tumors)
area of active clinical and basic science research,
avoid enucleation and external beam radiation
Indications
for patients who have visual potential in eyes containing tumors that are too large to
treat with focal methods.
In patient with extra-ocular disease
Subgroup of patient with introcular disease with high risk histologic features.
Patient with bilateral disease in conjunction with Aggressive local therapy.
Currently, six cycles of vincristine, carboplatin and etoposide are employed as
the standard starting regimen.
47. Treatment recommendations
Unilateral
intraocular
Laser therapy alone, or chemoreduction×6c → focal therapy.
Focal therapy options include:
EBRT (35–46 Gy) for small tumors located within macula, diffuse
vitreous seeding, or multifocal tumors
Cryotherapy for lesions <4 DD in the anterior Retina
Photocoagulation for posteriorly located tumors <4 DD distinct
from the optic nerve head and macula
Episcleral plaque brachytherapy is used for either focal
unilateral disease or recurrent disease following prior EBRT
Enucleation if the tumor is massive or if the eye is unlikely to have
useful vision after treatment
48. Bilateral
Each eye is assessed individually. The worse eye is no longer
routinely enucleated. If there is potential vision preservation
in both eyes, bilateral chemoreduction ± EBRT
with close follow-up for focal treatment may be used
Extraocular Orbital EBRT + chemo for palliation.
Trilateral
Retinoblastoma
Treat eyes as above. Neurosurgical resection, chemo,
with cranial RT or CSI. MS is only 11 months, but as
high as 24 months if caught early
49. Follow up
1st 6 months: 4-6 week intervals
Upto 3 years: at 4-6 month intervals
Later, yearly
Family history positive: all family members [other children at birth]
should be examined yearly
Editor's Notes
The normal retina extends from the posterior “pole” forward to a region just behind the lens, in cross-section called the ora serrata. The anterior chamber of the eye is between the cornea and the iris; the posterior chamber is just behind it, between the iris and the lens.Behind the lens is the vitreous chamber, with vitreous humor, a thick clear gel-like substance. In advanced retinoblastoma, “seeding” of the tumor is noted in this chamber.
The Reese- Ellsworth classification, still the most widely used retinoblastoma organization system, is based on intraocular tumor staging and globe salvage prediction after EBRT; survival is not taken into account in this categorization.