RESUMO
Background: retinoblastoma is the most common primary, malignant intraocular tumor of childhood, the aim of the study is to evaluate the outcome of management of 50 consecutive cases of unilateral retinoblastoma
Aims of the Work: to evaluate the outcome of management of unilateral retinoblastoma and to assess the risk of recurrence
Patients and Methods: prospective study of 50 consecutive cases with unilateral intraocular retinoblastoma. The management of cases was performed in the National eye center [Rod El Farag]. Fundus examination was done under general anesthesia with RetCam 3. Management of cases according to the staging was group A: Focal treatment, TTT or cryotherapy, group B and C: chemotherapy with focal treatment, group D: If the patient has good visual potential [according to macular affection] Chemotherapy with focal treatment, if the patient has poor visual potential Enucleation, group E Enucleation
Results: as regard cases that managed with chemotherapy, there was 23 cases, 13 out of them treated with chemotherapy and transpupillary thermotherapy and showed complete regression, 10 cases showed initial regression with further new tumor recurrence after finishing chemotherapy, 5 cases was well managed by focal therapy, and another 5 cases failed to be controlled by focal therapy and Intra vitreal melphalan and ended by enucleation. As regard cases that was managed by enucleation, there was 32 cases, 27 out of them managed by primary enucleation, and 5 cases managed by secondary enucleation after failure of chemotherapy and focal therapy, 17 cases out of the enucleated eyes revealed presence of high risk pathological features, none of the cases developed local or metastatic tumors in the follow up period
Conclusion: retinal seeding, vitreous seeding are major predictive factors for tumor recurrence