Ocular and orbital complications following the treatment of retinoblastoma.
OBJECTIVE
To investigate the ocular and orbital complications observed in children treated for retinoblastoma.


METHODS
We retrospectively studied 73 children (39 boys, 34 girls) suffering from retinoblastoma. Thirty-six had bilateral tumor and 37 unilateral disease for a total of 109 eyes affected. The follow-up was 6-180 months (median 36 months). Enucleation was the most common initial treatment approach in the unilateral group, and radiotherapy (by external beam) was the most common initial therapy in the bilateral group. Cryotherapy, photocoagulation, brachytherapy and/or systemic chemotherapy were used as adjuvant treatments when necessary. Ocular complications were recorded at the follow-up examinations.


RESULTS
Cataract developed in 20% of the irradiated eyes. The mean time from irradiation until development of cataract was 28.5 months (6-64 months). Radiation retinopathy developed in 12% and was first detected 11-72 months (mean 37 months) after irradiation therapy. Mild transient keratopathy was observed in all eyes undergoing irradiation, and xerophthalmia in one eye. Complications after enucleation included: marked discharge from the socket (11.0%), extrusion of the implant (9.6%), and contraction of the socket (3.0%). No complications were observed after cryotherapy or laser photocoagulation of the tumor.


CONCLUSIONS
Ocular complications after treating children with retinoblastoma are common and may seriously affect the quality of life of children surviving the primary malignancy.
Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
I
I
Anteby
N
N
Ramu
L
L
Gradstein
H
H
Miskin
J
J
Pe'er
D
D
Benezra
D001918:Brachytherapy / Q000009:adverse effects; D002386:Cataract / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery / Q000009:adverse effects; D015353:Eye Enucleation / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D017075:Laser Coagulation / Q000009:adverse effects; D007908:Lens, Crystalline / Q000528:radiation effects; D008297:Male; D009916:Orbital Diseases / Q000209:etiology*; D011183:Postoperative Complications; D011832:Radiation Injuries / Q000209:etiology*; D012160:Retina / Q000528:radiation effects; D012164:Retinal Diseases / Q000209:etiology*; D019572:Retinal Neoplasms / Q000628:therapy*; D012175:Retinoblastoma / Q000628:therapy*; D012189:Retrospective Studies