Classification and management of seeds in retinoblastoma. Ellsworth Lecture Ghent August 24th 2013.

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Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Classification and management of seeds in retinoblastoma. Ellsworth Lecture Ghent August 24th 2013.
Journal
Ophthalmic Genetics
Author(s)
Munier F.L.
ISSN
1744-5094 (Electronic)
ISSN-L
1381-6810
Publication state
Published
Issued date
2014
Volume
35
Number
4
Pages
193-207
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
Retinoblastoma has the unique capacity to accelerate its own intra-ocular propagation by adopting semi-solid or even liquid growth properties through seeding. Until recently, the presence of any degree of seeding was mostly incompatible with successful conservative management, due to the multiresistant nature of the seeds. Surprisingly, this well-recognized retinoblastoma behavior has not undergone any detailed description of seeding patterns and anatomic sites. In this paper, we describe the phenotypic variability of seeds across the four possible intraocular seeding compartments and classify them into three fundamental types: namely dust, spheres, and clouds. We also provide an overview of the different therapeutic strategies developed for seeding, with special attention to intravitreal chemotherapy as the treatment of choice for vitreous and retro-hyaloid seeding. Finally, we propose criteria to enable assessment of the response to treatment by reporting seed regression patterns, as well as a clinical grading system for the retinal toxicity observed following intravitreal melphalan.
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29/01/2015 16:04
Last modification date
20/08/2019 14:21
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