title: Long-term visual outcomes in intraocular retinoblastoma with eye preservation.
abstract: OBJECTIVE
  Inconsistent data exist on long-term visual outcomes in survivors of retinoblastoma. No studies have been reported on role of ocular coherence tomography (OCT) in predicting visual acuity. We assessed visual acuity in patients with retinoblastoma treated at our center in whom affected eyes were preserved.
  
  
  METHODS
  Patients who had completed a 2-year follow-up and were more than 5 years of age at assessment were included. Clinical data were obtained from database and factors predicting visual acuity were analyzed. OCT was performed in these patients to assess central macular thickness (CMT).
  
  
  RESULTS
  Visual outcomes were assessed in 45 eyes of 43 patients, of which 38 (88 %) had bilateral retinoblastoma. The median age at diagnosis was 12 months. Sixty percent (27/45) had International classification of retinoblastoma group C or D disease with 40 % eyes showing macular lesions. The far visual acuity was better than 6/12 in 53 % (24/45), 6/12 to 6/60 in 40 % (18/45) and 6/60 in 7 % (6/60). Macular location and International classification of retinoblastoma predicted poor vision (p = 0.06 and 0.07, respectively). CMT was less than 200 μm in 3 of 36 eyes (8 %) and 1 eye showed epiretinal membrane. Radiotherapy was associated with foveal thinning (p = 0.003). Two of 3 eyes with foveal thinning had a vision of 6/60.
  
  
  CONCLUSIONS
  Good visual outcomes were observed in half of retinoblastoma patients treated with eye preservation. Macular location and International classification of retinoblastoma group C and D predicted poor visual acuity, while previous radiotherapy predicted foveal thinning, which was associated with poor visual acuity.
authors.affiliation: Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: A
authors.initials: A
authors.lastname: Batra
authors.affiliation: Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: N
authors.initials: N
authors.lastname: Pushker
authors.affiliation: Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: P
authors.initials: P
authors.lastname: Venkatesh
authors.affiliation: Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: T
authors.initials: T
authors.lastname: Arora
authors.affiliation: Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: R
authors.initials: R
authors.lastname: Tewari
authors.affiliation: Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India. sambakh@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Bakhshi
mesh_terms: D059248:Chemoradiotherapy; D002675:Child, Preschool; D019773:Epiretinal Membrane / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments; D011379:Prognosis; D019572:Retinal Neoplasms / Q000473:pathology* / Q000628:therapy; D012175:Retinoblastoma / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects
keywords: Ocular coherence tomography; Retinoblastoma; Survivorship; Vision