Strabismus management in retinoblastoma survivors

BMC Ophthalmol. 2024 Mar 13;24(1):114. doi: 10.1186/s12886-024-03379-9.

Abstract

Purpose: To report the result of strabismus surgery in eye-salvaged retinoblastoma (Rb) patients.

Methods: A retrospective case series including 18 patients with Rb and strabismus who underwent strabismus surgery after completing tumor treatment by a single pediatric ophthalmologist.

Results: A total of 18 patients (10 females and 8 males) were included with a mean age of 13.3 ± 3.0 (range, 2-39) months at the time tumor presentation and 6.0 ± 1.5 (range, 4-9) years at the time of strabismus surgery. Ten (56%) patients had unilateral and 8(44%) had bilateral involvement and the most common worse eye tumor's group was D (n = 11), C (n = 4), B (n = 2) and E (n = 1). Macula was involved by the tumors in 12 (67%) patients. The tumors were managed by intravenous chemotherapy (n = 8, 47%), intra-arterial chemotherapy (n = 7, 41%) and both (n = 3, 17%). After complete treatment, the average time to strabismus surgery was 29.9 ± 20.5 (range, 12-84) months. Except for one, visual acuity was equal or less than 1.0 logMAR (≤ 20/200) in the affected eye. Seven (39%) patients had exotropia, 11(61%) had esotropia (P = 0.346) and vertical deviation was found in 8 (48%) cases. The angle of deviation was 42.0 ± 10.4 (range, 30-60) prism diopter (PD) for esotropic and 35.7 ± 7.9 (range, 25-50) PD for exotropic patients (P = 0.32) that after surgery significantly decreased to 8.5 ± 5.3 PD in esotropic cases and 5.9 ± 6.7 PD in exotropic cases (P < 0.001). The mean follow-up after surgery was 15.2 ± 2.0 (range, 10-24) months, in which, 3 (17%) patients needed a second surgery.

Conclusion: Strabismus surgery in treated Rb is safe and results of the surgeries are acceptable and close to the general population. There was not associated with tumor recurrence or metastasis.

Keywords: Chemotherapy; Retinoblastoma; Strabismus; Surgery.

MeSH terms

  • Adolescent
  • Child
  • Esotropia* / surgery
  • Exotropia* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neoplasm Recurrence, Local
  • Oculomotor Muscles / surgery
  • Ophthalmologic Surgical Procedures / methods
  • Retinal Neoplasms* / complications
  • Retinal Neoplasms* / surgery
  • Retinoblastoma* / complications
  • Retinoblastoma* / surgery
  • Retrospective Studies
  • Strabismus* / surgery
  • Treatment Outcome