Presence of cataract in patients treated for retinoblastoma at the national institute of pediatrics in Mexico (2011-2021).

PURPOSE: The goal of this study is to describe the presence of secondary cataract in patients with retinoblastoma treated at the National Institute of Pediatrics of Mexico (INP) over the past 10 years. METHODS: This was a single center observational, retrospective and descriptive study. We included all eyes diagnosed with retinoblastoma and cataract between June 2011 and June 2021. RESULTS: In total, 833 records of patients diagnosed with Retinoblastoma at the National Institute of Pediatrics during the period between June 2011 and June 2021 were reviewed. Out of all of them, only 14 developed cataract (1.6%). The median age at retinoblastoma diagnosis was 10.5 months (Rank: 6-13 months), and the median age at cataract diagnosis was 51.5 months (Rank: 25-73 months). The majority (13, 92.9%) of the patients had bilateral involvement. 42% of the eyes were Stage D according to the international classification of retinoblastoma. Cryotherapy was applied in 57.1%, intravitreal chemotherapy in 85.7%, radiation therapy in 42.6%, and only 7.1% of cases were treated with intra-arterial chemotherapy. CONCLUSIONS: The presence of cataract in patients with retinoblastoma is a rare but important entity impacting the development of vision in children and detection of intraocular tumors. These probably occur late as a result of the multiple treatments to which the children have been subjected, without being able to determine in this study which is the risk factor most associated with the development of this pathology.

Injerto dermograso para cavidad anoftálmica en niños enucleados por retinoblastoma / Dermal-fat graft for anophthalmic socket in children enucleated for retinoblastoma

El retinoblastoma (RB) es el tumor intraocular maligno más frecuente en niños. El tratamiento definitivo es la enucleación. El manejo de la anoftalmia consiste en colocar una esfera plástica dentro del cono muscular. Sin embargo, estos implantes suelen extruirse y tienen alto coste. Los injertos dermograsos minimizan el riesgo de hipoplasia hemifacial. Se ha observado que estos injertos crecen junto con el macizo facial y ayudan a expandir los huesos orbitarios limitando las consecuencias físicas y psicológicas. OBJETIVO: Describir la presencia de hipoplasia facial usando imágenes de resonancia después la colocación de injerto dermograso en pacientes enucleados por RB. MÉTODO: Se incluyeron pacientes de RB enucleados a quienes se les colocó injerto dermograso y se les hizo resonancia magnética en el Instituto Nacional de Pediatría durante el periodo junio de 2010 a diciembre de 2012. Se midió el crecimiento facial y la cosmeticidad. RESULTADOS: Se incluyeron 12 pacientes de 6 a 41 meses de edad al momento de la enucleación y colocación de injerto dermograso por diagnóstico de RB. A los 24 meses ninguno desarrolló hipoplasia hemifacial. Todos presentaron adecuada cosmeticidad con el uso de la prótesis. No se presentó ninguna complicación. CONCLUSIONES: El injerto dermograso es una opción adecuada para la cavidad anoftálmica en pacientes a los que se les realiza enucleación por RB

Retinoblastoma is the most frequent intraocular tumour in childhood. The definitive treatment is enucleation. The management of the anophthalmic socket consists in the use of a plastic implant. The problem is that they are expensive and they usually extrude. The use of dermal-fat grafts minimises the hemi-facial hypoplasia. They usually grow with the face, and help to expand the orbital bones, thus avoiding the psychological and physical consequences. OBJECTIVE: To determine if there is hemi-facial hypoplasia, using MRI images after the use of a dermal-fat implant in patients enucleated for RB. METHOD: The study included patients enucleated for RB in which a dermal-fat implant was used and MRI images were taken in the period between June 2010 and December 2012. Facial growth and cosmesis was measured. RESULTS: The study included 12 patients, aged between 6 to 41 months. After 24 months of follow up, none of them developed hemifacial hypoplasia. All had a good cosmesis with the prosthesis. There were no complications after the surgery. CONCLUSIONS: The use of dermal-fat implant is a good option for the anophthalmic socket in patients with RB after enucleation

Dermal-fat graft for anophthalmic socket in children enucleated for retinoblastoma. / Injerto dermograso para cavidad anoftálmica en niños enucleados por retinoblastoma.

Retinoblastoma is the most frequent intraocular tumour in childhood. The definitive treatment is enucleation. The management of the anophthalmic socket consists in the use of a plastic implant. The problem is that they are expensive and they usually extrude. The use of dermal-fat grafts minimises the hemi-facial hypoplasia. They usually grow with the face, and help to expand the orbital bones, thus avoiding the psychological and physical consequences. OBJECTIVE: To determine if there is hemi-facial hypoplasia, using MRI images after the use of a dermal-fat implant in patients enucleated for RB. METHOD: The study included patients enucleated for RB in which a dermal-fat implant was used and MRI images were taken in the period between June 2010 and December 2012. Facial growth and cosmesis was measured. RESULTS: The study included 12 patients, aged between 6 to 41 months. After 24 months of follow up, none of them developed hemifacial hypoplasia. All had a good cosmesis with the prosthesis. There were no complications after the surgery. CONCLUSIONS: The use of dermal-fat implant is a good option for the anophthalmic socket in patients with RB after enucleation.

Manifestaciones oculares y sistémicas del síndrome de Möebius / Eye and systemic manifestations of Mobius syndrome

INTRODUCCIÓN: El síndrome de Möebius es una enfermedad caracterizada por lesión en los núcleos del sexto y séptimo nervios craneales, produciendo parálisis facial y limitación a la abducción principalmente. El objetivo es describir los hallazgos oftalmológicos del síndrome de Möebius en niños mexicanos. PACIENTES Y MÉTODOS: Estudio retrospectivo, transversal, observacional y descriptivo. Se revisaron expedientes clínicos de los pacientes con síndrome de Möebius del Instituto Nacional de Pediatría de México atendidos entre los años 2000 y 2010. RESULTADOS: Se revisaron 64 expedientes clínicos. Los hallazgos más importantes fueron limitación a la abducción (100%), parálisis facial (100%) endotropia (54%), epicanto (51,5%), entropión (22%) y antecedente de uso de abortivos en la madre durante el primer trimestre de embarazo (28%). Sin embargo, también se presentaron hallazgos atípicos como exotropia e hipertropia. CONCLUSIONES: El síndrome de Möebius tiene una amplia gama de manifestaciones oftalmológicas que se deben detectar temprano para mejorar su función y estética

INTRODUCTION: Mobius syndrome is characterized by damage in the nucleus of the sixth and seventh cranial nerves, with subsequent facial palsy and abduction limitation of the eyes. The aim of this article is to describe the ophthalmological findings of the Mobius syndrome in Mexican children. PATIENTS AND METHODS: A cross-sectional, retrospective, observational and descriptive study was conducted. A review was made of the clinical charts of patients with Mobius syndrome who were seen in the National Institute of Pediatrics in Mexico, between the years 2000 and 2010. RESULTS: A total of 64 charts were reviewed. The most important findings were eye abduction limitation (100%), facial palsy (100%), esotropia (54%), epicanthus (51.5%), entropion (22%), and history of use of abortion inducers in the mother in the first trimester of pregnancy (28%). We also found exotropia and hypertropia in some cases. CONCLUSIONS: Mobius syndrome has a wide spectrum of ophthalmological manifestations that are important to detect early in order to improve function and esthetics

[Eye and systemic manifestations of Mobius syndrome]. / Manifestaciones oculares y sistémicas del síndrome de Möebius.

INTRODUCTION: Mobius syndrome is characterized by damage in the nucleus of the sixth and seventh cranial nerves, with subsequent facial palsy and abduction limitation of the eyes. The aim of this article is to describe the ophthalmological findings of the Mobius syndrome in Mexican children. PATIENTS AND METHODS: A cross-sectional, retrospective, observational and descriptive study was conducted. A review was made of the clinical charts of patients with Mobius syndrome who were seen in the National Institute of Pediatrics in Mexico, between the years 2000 and 2010. RESULTS: A total of 64 charts were reviewed. The most important findings were eye abduction limitation (100%), facial palsy (100%), esotropia (54%), epicanthus (51.5%), entropion (22%), and history of use of abortion inducers in the mother in the first trimester of pregnancy (28%). We also found exotropia and hypertropia in some cases. CONCLUSIONS: Mobius syndrome has a wide spectrum of ophthalmological manifestations that are important to detect early in order to improve function and esthetics.