title: Abnormal orbital growth in children submitted to enucleation for retinoblastoma treatment.
abstract: Enucleation is typically performed for the treatment of advanced retinoblastoma in children. After enucleation, the orbit undergoes abnormal development. In this study, orbital asymmetry was calculated using computed tomography measurements obtained from patients who experienced enucleation for unilateral retinoblastoma. Influence factors analyzed included: type of treatment, use of orbital implants, and patient's age at diagnosis. A total of 42 children underwent enucleation with a mean follow-up period of 4.8 years. For 28 patients, treatment included enucleation alone, 14 patients received enucleation plus radiation therapy. Thirty patients kept orbital implants long term. The mean orbital volume asymmetry for treated versus contralateral orbits was 16.8%. Mean asymmetry in orbital volume was greater for patients who underwent enucleation combined to radiation therapy (23.7% vs. 13.3%, P=0.05) and for patients without long-term maintenance of the prosthetic implants (29.3% vs. 11.8%, P<0.01). In conclusion, orbital volume is abnormally affected in children after enucleation of 1 eye for the treatment of retinoblastoma, and computed tomography can precisely quantify the asymmetry that develops. Orbital implants improve volumetric growth after enucleation, with 2-fold greater orbital asymmetry achieved without an implant.
authors.affiliation: Department of Ophthalmology, Universidade Santo Amaro, São Paulo, Brazil. chojniak@uol.com.br
authors.forename: Martha Maria Motono
authors.initials: MM
authors.lastname: Chojniak
authors.forename: Rubens
authors.initials: R
authors.lastname: Chojniak
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Testa
authors.forename: Tjioe Tjia
authors.initials: TT
authors.lastname: Min
authors.forename: Marcos Duarte
authors.initials: MD
authors.lastname: Guimarães
authors.forename: Andréa Maria
authors.initials: AM
authors.lastname: Barbosa E Silva
authors.forename: Célia Beatriz Gianotti
authors.initials: CB
authors.lastname: Antoneli
mesh_terms: D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009915:Orbit / Q000254:growth & development / Q000473:pathology*; D011379:Prognosis; D019572:Retinal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012175:Retinoblastoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed