Skip to main content

Orbital Retinoblastoma: Diagnosis and Management

  • Chapter
  • First Online:
  • 563 Accesses

Abstract

Orbital retinoblastoma is a potentially fatal disease. It is more prevalent in the developing world where delay in presentation and lack of access to healthcare contribute to poor survival rates. However, with the evolution of a multimodal therapy, the prognosis for survival has improved significantly. The current treatment protocols use a combination of high-dose systemic chemotherapy, followed by appropriate surgery, radiotherapy, and adjuvant chemotherapy. This chapter discusses in detail the clinical spectrum of orbital retinoblastoma, classification and subtypes, evaluation and investigations, strategies for management, and future perspectives.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Ellsworth RM. Orbital retinoblastoma. Trans Am Ophthalmol Soc. 1974;72:79–88.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Grabowski EF, Abramson DH. Intraocular and extra ocular retinoblastoma. Hematol Oncol Clin North Am. 1987;1:721–35.

    Article  CAS  Google Scholar 

  3. Kao LY, Su WW, Lin YW. Retinoblastoma in Taiwan: survival and clinical characteristics 1978-2000. Jpn J Ophthalmol. 2002;46:577–80.

    Article  Google Scholar 

  4. Badhu B, Sah SP, Thakur SK, et al. Clinical presentation of retinoblastoma in Eastern Nepal. Clin Exp Ophthalmol. 2005;33:386–9.

    Article  Google Scholar 

  5. Chawla B, Hasan F, Azad R, et al. Clinical presentation and survival of retinoblastoma in Indian children. Br J Ophthalmol. 2015;100:172–8.

    Article  Google Scholar 

  6. Leal-Leal C, Flores-Rojo M, Medina-Sansón A, et al. A multi-centre report from the Mexican retinoblastoma group. Br J Ophthalmol. 2004;88:1074–7.

    Article  CAS  Google Scholar 

  7. Magramm I, Abramson DH, Ellsworth RM. Optic nerve involvement in retinoblastoma. Ophthalmology. 1989;96:217–22.

    Article  CAS  Google Scholar 

  8. Rootman J, Ellsworth RM, Hofbauer J, et al. Orbital extension of retinoblastoma: a clinicopathological study. Can J Ophthalmol. 1978;13:72–80.

    CAS  PubMed  Google Scholar 

  9. Stannard C, Lipper S, Sealy R, et al. Retinoblastoma: correlation of invasion of the optic nerve and choroid with prognosis and metastases. Br J Ophthalmol. 1979;63:560–70.

    Article  CAS  Google Scholar 

  10. Schvartzman E, Chantada G, Fandino A, et al. Results of a stage-based approach for the treatment of retinoblastoma. J Clin Oncol. 1996;14:1532–6.

    Article  CAS  Google Scholar 

  11. Finger PT, Harbour JW, Karcioglu ZA. Risk factors for metastasis in retinoblastoma. Surv Ophthalmol. 2002;47:1–16.

    Article  Google Scholar 

  12. Kopelman JE, McLean IW, Rosenberg SH. Multivariate analysis of risk factors for metastasis in retinoblastoma treated by enucleation. Ophthalmology. 1987;94:371–7.

    Article  CAS  Google Scholar 

  13. Kauffman EC, Robinson VL, Stadler WM, et al. Metastasis suppression: the evolving role of metastasis suppressor genes for regulating cancer cell growth at the secondary site. J Urol. 2003;169:1122–33.

    Article  Google Scholar 

  14. Singh AD, Shields CL, Shields JA. Prognostic factors in retinoblastoma. J Pediatr Ophthalmol Strabismus. 2000;37:134–41.

    CAS  PubMed  Google Scholar 

  15. Sanders BM, Draper GJ, Kingston JE. Retinoblastoma in Great Britain 1969-80: incidence, treatment, and survival. Br J Ophthalmol. 1988;72:576–83.

    Google Scholar 

  16. Chantada G, Doz F, Antoneli CB, et al. A proposal for an international retinoblastoma staging system. Pediatr Blood Cancer. 2006;47:801–5.

    Article  Google Scholar 

  17. Chawla B, Kumar K, Singh AD. Influence of socioeconomic and cultural factors on retinoblastoma management. Asia Pac J Oncol Nurs. 2017;4:187–90.

    Article  Google Scholar 

  18. Shields JA, Shields CL. Intraocular tumours: a text and atlas. Philadelphia: WB Saunders; 1992.

    Google Scholar 

  19. Doz F, Khelfaoui F, Mosseri V, et al. The role of chemotherapy in orbital involvement of retinoblastoma. The experience of a single institution with 33 patients. Cancer. 1994;74:722–32.

    Article  CAS  Google Scholar 

  20. Antoneli CB, Steinhorst F, de Cássia Braga Ribeiro K, et al. Extraocular retinoblastoma: a 13-year experience. Cancer. 2003;98:1292–8.

    Article  Google Scholar 

  21. Menon BS, Reddy SC, Maziah WM, et al. Extraocular retinoblastoma. Med Pediatr Oncol. 2000;35:75–6.

    Article  CAS  Google Scholar 

  22. Honavar SG, Manjandavida FP, Reddy VP. Orbital retinoblastoma: an update. Indian J Ophthalmol. 2017;65:435–42.

    Article  Google Scholar 

  23. Chawla B, Seth R, Moksha L. Chemotherapy for ocular cancers. In: Pharmacology of ocular therapeutics. Cham: Springer International Publishing; 2016. p. 333–58.

    Chapter  Google Scholar 

  24. Amin MB, Edge SB, Greene FL, et al. Retinoblastoma. In: AJCC cancer staging manual, Ch. 68. 8th ed. New York: Springer; 2017. p. 819–31.

    Chapter  Google Scholar 

  25. Chawla B, Duraipandi K, Sharma S. MRI in retinoblastoma associated orbital cellulitis. Ophthalmology. 2013;120:1308–9.

    Article  Google Scholar 

  26. Hungerford J. Factors influencing metastasis in retinoblastoma. Br J Ophtalmol. 1993;77:541.

    Article  CAS  Google Scholar 

  27. Reese AB. Tumors of the eye. New York: Harper and Row; 1963. p. 155–6.

    Google Scholar 

  28. Chawla B, Hada M, Seth R, et al. Trabeculectomy in eyes with unsuspected retinoblastoma. Ophthalmic Genet. 2016;37:437–40.

    Article  Google Scholar 

  29. Vemuganti GK, Honavar SG, John R. Clinicopathological profile of retinoblastoma in Asian Indians. Invest Ophthalmol Vis Sci. 2000;41:790.

    Google Scholar 

  30. Chawla B, Sharma S, Sen S, et al. Correlation between clinical features, MRI and histopathologic findings in retinoblastoma: a prospective study. Ophthalmology. 2012;119:850–6.

    Article  Google Scholar 

  31. Kiratli PO, Kiratli H, Ercan MT. Visualization of orbital retinoblastoma with technetium-99m (V) dimercaptosuccinic acid. Ann Nucl Med. 1998;12:157–9.

    Article  CAS  Google Scholar 

  32. Moll AC, Hoekstra OS, Imhof SM, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography (PET) to detect vital retinoblastoma in the eye: preliminary experience. Ophthalmic Genet. 2004;25:31–5.

    Article  CAS  Google Scholar 

  33. Honavar SG, Singh AD. Management of advanced retinoblastoma. Ophthalmol Clin North Am. 2005;18:65–73.

    Article  Google Scholar 

  34. White L. Chemotherapy in retinoblastoma: current status and future directions. Am J Pediatr Hematol Oncol. 1991;13:189–201.

    Article  CAS  Google Scholar 

  35. Goble RR, McKenzie J, Kingston JE, et al. Orbital recurrence of retinoblastoma successfully treated by combined therapy. Br J Ophthalmol. 1990;74:97–8.

    Article  CAS  Google Scholar 

  36. Chawla B, Hasan F, Seth R, et al. Multimodal therapy for stage III retinoblastoma (International Retinoblastoma Staging System). Ophthalmology. 2016;123:1933–9.

    Article  Google Scholar 

  37. Chawla B, Khurana S, Sen S, et al. Clinical misdiagnosis of retinoblastoma in Indian children. Br J Ophthalmol. 2014;98:488–93.

    Article  Google Scholar 

  38. Kim JW, Kathpalia V, Dunkel IJ, et al. Orbital recurrence of retinoblastoma following enucleation. Br J Ophthalmol. 2009;93:463–7.

    Article  CAS  Google Scholar 

  39. Kremens B, Wieland R, Rienhart H, et al. High dose chemotherapy with autologous stem cell in children with retinoblastoma. Bone Marrow Transplant. 2003;31:281–4.

    Article  CAS  Google Scholar 

  40. Lee SH, Yoo KH, Sung KW, et al. Tandem high-dose chemotherapy and autologous stem cell rescue in children with bilateral advanced retinoblastoma. Bone Marrow Transplant. 2008;42:385–91.

    Article  CAS  Google Scholar 

  41. Munier FL, Verwey J, Pica A, et al. New developments in external beam radiotherapy in retinoblastoma from lens to normal tissue-sparing techniques. Clin Exp Ophthalmol. 2008;36:78–89.

    Article  Google Scholar 

  42. Maat-Kievit JA, Oepkes D, Hartwing NG. A large retinoblastoma detected in a fetus at 21 weeks of gestation. Prenat Diagn. 1993;13:377–84.

    Article  CAS  Google Scholar 

  43. Salim A, Wiknjosastro GH, Danukusumo D. Fetal retinoblastoma. J Ultrasound Med. 1998;17:717–20.

    Article  CAS  Google Scholar 

  44. Parsam VL, Kannabiran C, Honavar SG, et al. A comprehensive, sensitive and economical approach for the detection of mutations in RB1 gene in retinoblastoma. J Genet. 2009;88:517–27.

    Article  CAS  Google Scholar 

  45. Chawla B, Singh R. Recent advances and challenges in the management of retinoblastoma. Ind J Ophthalmol. 2017;65:133–9.

    Article  Google Scholar 

  46. Wolff JA, Boesel C, Ellsworth RM, et al. Children’s Cancer Study Group Protocol CCSG 962. New York: Childrens Cancer Group; 1978.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chawla, B., Hada, M. (2019). Orbital Retinoblastoma: Diagnosis and Management. In: Berry, J., Kim, J., Damato, B., Singh, A. (eds) Clinical Ophthalmic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-11123-6_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-11123-6_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-11122-9

  • Online ISBN: 978-3-030-11123-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics