Managing the consequences of aggressive conservative treatment for refractory retinoblastoma with vitreous seeding Lidando com as consequências do tratamento agressivo para retinoblastoma refratário com semeadura vítrea

Retinoblastoma remains the most common pediatric intraocular tumor. While current therapies have significantly limited patient mortality, the focus has recently shifted towards eye-preserving treatments. These new eye-preserving therapies are particularly relevant to 40% of the RB cases that are bilateral. Periocular chemotherapy, selective ophthalmic artery infusion chemotherapy (SOAIC), and intravitreal (IVit) chemotherapy are relatively recent therapeutic options that have shown potential for eye-preservation. The ultimate goal of these therapies is to deliver a locally toxic dose of chemotherapeutic agent while avoiding the systemic side effects seen in intravenous chemotherapy. Periocular carboplatin has been used to deliver a high, stable con centration of chemotherapeutic agents by sub-Tenon injection. Reports indicated a favorable clinical response with tumor regression, but long-term fol low-ups have shown tumor recurrence and disease progression in the eyes treated with periocular carboABSTRACT