title: Ophthalmic vasculature alterations following systemic chemotherapy and periocular Carboplatin treatment of advanced retinoblastoma.
abstract: The purpose of this study was to report significant alterations in orbital vasculature following combined systemic chemoreduction/laser ablation and periocular carboplatin treatment and to discuss treatment implications in two cases of advanced retinoblastoma. Assessment of orbital and ophthalmic vasculature was done following nine cycles of systemic chemotherapy. Intra-arterial chemotherapy was provided 6 months following completion of systemic chemoreduction, when the tumor was clearly active and progressive. Orbital angiography of both eyes, performed prior to the intra-arterial melphalan injection, documented sclerosis of the ophthalmic artery vasculature with delayed transit time, decreased choroidal blush, and anomalous vessels in the eye receiving periocular carboplatin injections. The orbital vasculature in the contralateral eye was not affected. Orbital and ophthalmic vascular alterations may occur with the use of combined systemic chemotherapy and periocular carboplatin. Systemic chemotherapy and focal transpupillary laser tumor ablation, alone, did not appear to impact the orbital and ophthalmic vascular supply. Impaired vascular supply may have significant influence on the impact of the efficacy of standard and future experimental therapeutic options.
authors.affiliation: Bascom Palmer Eye Institute, Miami, Florida, USA.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Piña
authors.forename: Hinda
authors.initials: H
authors.lastname: Boutrid
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Murray
authors.forename: Stacey Quintero
authors.initials: SQ
authors.lastname: Wolfe
authors.forename: Amy C
authors.initials: AC
authors.lastname: Schefler
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Houston
authors.forename: Roham
authors.initials: R
authors.lastname: Moftakhar
authors.forename: Cristina E
authors.initials: CE
authors.lastname: Fernandes
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reichbach
authors.forename: Hassan A
authors.initials: HA
authors.lastname: Aziz
authors.forename: Arnold M
authors.initials: AM
authors.lastname: Markoe
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Aziz-Sultan
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects; D010478:Chemotherapy, Cancer, Regional Perfusion; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000627:therapeutic use; D005047:Etoposide / Q000009:adverse effects; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007223:Infant; D007269:Injections, Intra-Arterial; D017075:Laser Coagulation / Q000009:adverse effects*; D009880:Ophthalmic Artery / Q000473:pathology*; D012161:Retinal Artery / Q000473:pathology*; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012175:Retinoblastoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012598:Sclerosis / Q000139:chemically induced; D014750:Vincristine / Q000009:adverse effects
chemical_list: D014750:Vincristine; D005047:Etoposide; D016572:Cyclosporine; D016190:Carboplatin