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Agnieszka Kubicka-Trząska, Izabella Karska-Basta, Joanna Kobylarz, Bożena Romanowska-Dixon
Am J Case Rep 2010; 11:60-63
Background: As conservative treatments for retinoblastoma become more prevalent, the number of ocular complications developing in eyes that previously would have been enucleated is growing.
Case Report: The aim of the study is to present the case of a 19-year-old patient who was referred to this department at the age of 7 months with suspected bilateral retinoblastoma. One month later, enucleation of the right eye (Reese-Ellswoth group V) was performed and histopatological examination confirmed retinoblastoma. Brachytherapy and xenon arc photocoagulations were performed in the left eye. After the treatment, visual acuity (VA) of the left eye was 1.0. At the age of 17 years, intravitreal hemorrhage occurred in the left eye. As a result of pharmacological treatment, proper function of the left eye was restored. After two subsequent hemorrhages, VA was restricted to hand movements. The left eye was qualified for pars plana vitrectomy (PPV) with silicon oil tamponade. The follow-up examinations showed improvement of VA to 0.5. The patient passed her high school final exams. She has remained under ophtalmological and oncological supervision. Observation has shown no recurrence or metastatic spread of the tumor.
Conclusions: PPV with silicone oil endotamponade can be regarded as a treatment option in complicated cases of retinoblastoma. However, it may be associated with risks of tumor recurrence and systemic dissemination; therefore this technique should be reserved for patients with no alternative for preserving vision.