Visual Acuity Results after Management of Retinoblastoma in Children

In this study we evaluated long-term functional results of different methods of retinoblastoma treatment including chemoreduction with carboplatine, etoposide and vincristine, chemothermotherapy, cryotherapy, diode laser thermotherapy, photocoagulation and external beam radiation. The group investigated involved 54 eyes of 43 patients treated in the period from 1985 to 1998. Thirty-two patients had unilateral and 11 had bilateral retinoblastoma. The mean follow-up was 8.6 years (range, 4 to 15). The visual acuity outcome was assessed in 31 eyes of 27 children because 23 eyes with ReeseEllsworth stage IV to V retinoblastoma had to be enucleated. The mean visual acuity of the successfully treated eyes was 6/18. Fourteen eyes had a visual acuity better than 6/12 , nine eyes had a visual acuity between 6/60 and 6/12 and eight eyes had a visual acuity less than 6/60. Maculopathy was observed in 11 eyes. Ten eyes were free from any treatment-related complications. It is concluded that chemotherapy combined with additional focal treatments resulted in good outcome in eyes with Reese-Ellsworth stage I to III retinoblastoma. Children with early and correctly diagnosed retinoblastoma now have a good prognosis for life.