Resolution of iris neovascularization following chemoreduction of advanced retinoblastoma.

Iris neovascularization (NVI) in eyes with newly diagnosed retinoblastoma is a hallmark of advanced tumor. These eyes often display secondary glaucoma and additional partial or complete retinal detachment. From a clinical perspective, NVI with secondary glaucoma is noted in approximately 12% of eyes with retinoblastoma, and from a pathology perspective, NVI has been found in 44% of eyes following enucleation. Iris neovascularization is considered a poor prognosis for globe salvage and vision; thus, enucleation is typically advised. Eyes with advanced retinoblastoma can show a favorable response to chemoreduction. We have had experience with 2 patients with bilateral advanced retinoblastoma who each showed evidence of NVI in one eye. Because both eyes were possibly destined for enucleation, chemoreduction was provided. Fortunately, the NVI resolved by 1-month follow-up and neovascular glaucoma was avoided.