Transpupillary thermotherapy in children with retinoblastoma: 10-year experience

Author: Denis Volodin (Russian Federation)

Co-authors: Andrey Yarovoy, Vera Yarovaya, Elena Kotova, Amina Chochaeva

Purpose

To evaluate the efficacy of transpupillary thermotherapy for retinoblastoma.

Setting/Venue

National Medical Research Center Academician S.N. Fyodorov Intersectoral Scientific and Technical Complex “Eye microsurgery”, Ministry of Health of Russia; 59a Beskudnikovsky Blvd., Moscow, 127486, Russia

Methods

In a retrospective study, we reviewed case series of 177 children with retinoblastoma (1156 tumors in 224 eyes) treated with transpupillary thermotherapy at the S. Fyodorov Eye Microsurgery Federal State Institution in Moscow between October 2011 and December 2020. The median patient age at the time of treatment was 16.8 months. The mean tumor thickness was 1.1 mm (from 0.2 to 4.5), the mean basal diameter was 2.2 mm (from 0.3 to 13.4). Transpupillary thermotherapy was performed using a diode laser with the following parameters: wave length-810 nm, spot diameter-1200 microns, power from 200 to 800 mW (mean - 350 mW), exposure-from 3 to 15 s in the application mode, and continuous in the scanning mode.

Results

Overall tumor control was achieved in 92.7% (1072 tumors). Tumor recurrence was observed in 7% (82 tumors) and these tumors were treated with other local methods. 209 eyes (93%) were preserved. 15 eyes (7%) were enucleated due to tumor progression, total retinal detachment, vitreous hemorrhage or subatrophy of the eyeball. Complications after transpupillary thermotherapy included local vitreous hemorrhage (2 eyes; 0.9%), pretumoral hemorrhage (3 eyes, 1.3%), local vitreous opacities (2 eyes; 0.9%), iris atrophy and anterior synechiae (1 eye, 0.45%). The median follow-up was 35.5 months.

Conlusions

Transpupillary thermotherapy is an effective treatment for retinoblastoma with excellent local tumor control and few complications. It can be used for destruction of small primary tumors of both post-equatorial and pre-equatorial localization, residual tumors after inefficiency of other local methods, and is also effective in the treatment of cavitary tumors located in functionally significant areas of the fundus.

Financial Disclosure

No

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