ERG monitoring of retinal function during systemic chemotherapy for retinoblastoma. Issue 6 (18th March 2012)

• Record Type: Journal Article
• Authors: Brodie, Scott E; Paulus, Yannis M; Patel, Mrinali; Gobin, Y Pierre; Dunkel, Ira J; Marr, Brian P; Abramson, David H
• Is Part Of: British journal of ophthalmology. Volume 96:Issue 6(2012)
• Page Start: 877
• Page End: 880
• Publication Date: 2012-03-18
• Subjects: Retinoblastoma -- chemotherapy -- electroretinography -- carboplatin -- cancer -- electrophysiology -- telemedicine -- psychophysics -- optics and refraction -- retina -- macula -- neoplasia -- iris -- treatment other -- conjunctiva -- ciliary body -- treatment lasers; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2011-301248
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Background/aims: We have previously introduced electroretinography (ERG) as a proxy for visual function to monitor for retinal toxicity due to intra-arterial chemotherapy for retinoblastoma in young children. In this paper, we report ERG results for patients with retinoblastoma receiving initial treatment with systemic chemotherapy. Methods: Inclusion criteria were patients presenting with retinoblastoma at <3 months of age or <6.0 kg in weight, with large tumours not amenable to local laser treatment, cryotherapy or plaque brachytherapy. Patients received intravenous carboplatin 18.7 mg/kg every 3–5 weeks, contingent on recovery of blood counts, until they had grown sufficiently to receive intra-arterial chemotherapy. ERG was performed during examination under anaesthesia at monthly intervals, using contact lens electrodes and a hand-held ganzfeld stimulator. 30-Hertz flicker responses are reported. Results: Four patients were treated for bilateral retinoblastoma. All eyes responded well to systemic chemotherapy. 30-Hertz flicker ERGs improved during treatment in all eyes, significantly in six of eight eyes, and at least in one eye of each patient. Conclusion: Effective systemic chemotherapy for retinoblastoma in children who are too small for intra-arterial chemotherapy is compatible with significant increases in ERG amplitudes, even in eyes presenting with extinguished ERGs. ERG signals may increase independent of resolution of retinal detachment.