Abstract
Purpose
To investigate the electrical responses of the retina in retinoblastoma (RB), by recording full-field electroretinography (ERG) under general anesthesia.
Methods
The ERG was recorded using Ephios hand-held portable ERG system, according to International Standards for Clinical Electrophysiology of Vision. Forty-eight eyes of 43 cases and 33 eyes of 33 controls were enrolled. The cases were classified based on international intraocular retinoblastoma classification (IIRC). Forty-eight eyes of cases were divided into 30 cases with active RB and 18 cases with regressed RB.
Results
The amplitudes of a- and b-waves were decreased as compared to controls in all subgroups. The implicit times of all RB patients from group A to C differed statistically from controls (p value < 0.05) except for single-flash rod response. The ERG waveforms in group E eyes were non-recordable. The comparison of ERG parameters between active and regressed groups (IIRC groups A and B) was statistically insignificant. Single case follow-up of unilateral RB after systemic chemotherapy showed improvement in amplitudes compared to baseline parameters.
Conclusions
Reduced amplitudes and delayed implicit times were noted in advanced disease. The ERG of RB cases did not follow any specific pattern of waveform. ERG appears to be a dynamic parameter to observe changes following treatment for RB. Although ERG is not a diagnostic test for RB, it can be used as a complementary test to assess the residual retinal function in RB eyes.
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References
Abramson DH, Schefler AC (2004) Update on retinoblastoma. Retina 24:828–848
Marmor MF, Fulton AB, Holder GE, Miayke Y, Briell M, Bach M (2008) ISCEV standard for full-field clinical electroretinography. Doc Ophthalmol 118:69–77
Brodie SE, Gobin YP, Dunkel IJ, Kim JW, Abramson DH (2009) Persistence of retinal function after selective ophthalmic artery chemotherapy infusion for retinoblastoma. Doc Ophthalmol 119:13–22
Abramson DH, Dunkel IJ, Brodie SE, Marr B, Gobin YP (2010) Superselective ophthalmic artery chemotherapy as primary treatment for retinoblastoma (chemosurgery). Ophthalmology 117:1623–1629
Lubiński W, Zajaczek S, Sych Z, Penkala K, Palacz O, Lubiński J (2002) Electroretinographic changes in the inner retinal layers of the retained eyes of patients with sporadic unilateral retinoblastoma. Ophthalmic Genet 23:99–107
Shields CL, Shields JA (2006) Basic understanding of current classification and management of retinoblastoma. Curr Opin Ophthalmol 17:228–234
Shields CL, Palamar M, Sharma P, Ramasubramanian A, Leahey A, Meadows AT, Shields JA (2009) Retinoblastoma regression patterns following chemoreduction and adjuvant therapy in 557 tumors. Arch Ophthalmol 127:282–290
Robanus-Maandag E, Dekker M, van der Vaik M, Carrozza ML, Jeanny JC, Dannenberg JH, Berns A, te Riele H (1998) p107 Is a suppressor of retinoblastoma development in pRb-deficient mice. Genes Dev 12:1599–1609
Johnson DA, Zhang J, Frase S, Wilson M, Rodriguez-Galindo C, Dyer MA (2007) Neuronal differentiation and synaptogenesis in retinoblastoma. Cancer Res 67:2701–2711
Nork TM, Schwartz TL, Doshi HM, Millechia LL (1995) Retinoblastoma cell of origin. Arch Ophthalmol 113:791–802
Gallie BL, Campbell C, Delvin H, Duckett A, Squire JA (1999) Development basis of retinal-specific induction or cancer by RB mutation. Cancer Res 59(7 Suppl):1731s–1735s
Poche R, Reese BE (2009) Retinal horizontal cells: challenging paradigms of neural development and cancer biology. Development 136:2141–2151
Tremblay F, Parkinson JE (2003) Alteration of electroretinographic recordings when performed under sedation of halogenate anesthesia in a pediatric population. Doc Ophthalmol 107:271–279
Andreasson S, Tornqvist K, Ehinger B (1993) Full field electroretinograms during general anesthesia in normal children compared to examination with topical anesthesia. Acta Ophthalmol 71:491–495
Acknowledgments
We thank Department of Biotechnology (DBT), India for funding the project (DBT Number-BT/MB/Indo-US-BR/01/2008).
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Sachidanandam, R., Krishnakumar, S., Gopal, L. et al. Full-field electroretinography under general anesthesia in retinoblastoma. Doc Ophthalmol 126, 149–157 (2013). https://doi.org/10.1007/s10633-012-9368-4
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DOI: https://doi.org/10.1007/s10633-012-9368-4