Ichemic Necroi and Atrophy of the Optic Nerve After Periocular Carboplatin Injection for Intraocular Retinoblatoma Original Reearch Article

Purpoe To report four cae of optic nerve neuropathy in three children treated with periocular carboplatin injection for unilateral or bilateral intraocular retinoblatoma. Deign Retropective, obervational cae erie. Method etting: Univerity-baed Ophthalmology Practice. tudy population: Four eye of three children with retinoblatoma enucleated after nonucceful multimodality treatment including periocular carboplatin injection. obervation procedure: The enucleated eye were routinely proceed and evaluated by light microcopy. A retropective chart review of all four cae wa performed. Reult Three enucleated eye (Reee-Ellworth group III and VB) were obtained from two children with bilateral multifocal retinoblatoma, and one eye (Reee-Ellworth group IIB) wa harveted from a child with unilateral retinoblatoma. All affected eye underwent three to even periocular carboplatin injection before enucleation. Additional treatment modalitie included ytemic chemotherapy, tranpupillary thermotherapy, trancleral cryotherapy, and external beam radiotherapy. Hitopathologic evaluation of the enucleated eye revealed focal area of ichemic necroi or atrophy of the optic nerve along with dytrophic calcification and mild inflammation in the urrounding fibrovacular adipoe tiue. Concluion Periocular injection of carboplatin may be a ueful treatment approach in the management of patient with advanced intraocular retinoblatoma and may minimize ytemic ide-effect. However, ophthalmologit and pediatric oncologit hould be aware of potential marked local complication with periocular carboplatin delivery, including ichemic optic neuropathy. Modifying the injection ite/location (for example, ubtenon pace) or adding other delivery route adjunct (for example, fibrin ealant) deerve further tudy.