PMID- 29921454
OWN - NLM
STAT- In-Data-Review
LR  - 20181015
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 125
IP  - 11
DP  - 2018 Nov
TI  - Ophthalmic Vascular Events after Primary Unilateral Intra-arterial Chemotherapy
      for Retinoblastoma in Early and Recent Eras.
PG  - 1803-1811
LID - S0161-6420(18)30560-8 [pii]
LID - 10.1016/j.ophtha.2018.05.013 [doi]
AB  - PURPOSE: To assess risk factors for ophthalmic vascular events after
      intra-arterial chemotherapy (IAC) for retinoblastoma. DESIGN: Retrospective
      cohort study. PARTICIPANTS: Patients who received unilateral IAC as primary
      treatment for retinoblastoma from January 1, 2009, to November 30, 2017, at a
      single center. METHODS: Records were reviewed for patient demographics, tumor
      features, IAC parameters, and treatment-related vascular events in the early IAC 
      era (2009-2011) compared with the recent era (2012-2017) using the t test and
      Fisher exact test. Change in event rates over time was assessed using Poisson
      regression analysis, with Spearman's rho used to test correlation. MAIN OUTCOME
      MEASURES: Rate of IAC-induced ophthalmic vascular events. RESULTS: There were 243
      chemotherapy infusions in 76 eyes of 76 patients, divided into early (22 eyes, 57
      infusions) and recent (54 eyes, 186 infusions) eras. Intra-arterial chemotherapy 
      consisted of melphalan (243 infusions), topotecan (124 infusions), and
      carboplatin (9 infusions). A comparison (early vs. recent era) revealed fewer
      mean number of infusions (2.6 vs. 3.4, P = 0.02) with similar mean patient age
      and presenting tumor features. Event rates decreased over time (P < 0.01), with
      fewer ophthalmic vascular events (early era vs. recent era) in the recent era
      (59% vs. 9% per eye, 23% vs. 3% per infusion, P < 0.01), including peripheral
      retinal nonperfusion (5% vs. 2% per eye, P = 0.50), vitreous hemorrhage (9% vs.
      2%, P = 0.20), subretinal hemorrhage (0% vs. 2%, P = 0.99), branch retinal vein
      occlusion (5% vs. 0%, P = 0.29), choroidal ischemia (14% vs. 4%, P = 0.14), and
      ophthalmic artery spasm/occlusion (27% vs. 0%, P < 0.01). Events did not
      correlate to patient age (P = 0.75), tumor diameter (P = 0.32), tumor thickness
      (P = 0.59), or cumulative dosage of melphalan (P = 0.13) or topotecan (P = 0.59).
      There were no IAC-induced vascular events in 72 infusions of 21 consecutively
      treated eyes in 2016 to 2017. CONCLUSIONS: Ophthalmic vascular events after IAC
      have decreased from the early era (2009-2011) through the current era (2012-2017)
      at this center. Experience performing this highly specialized procedure could be 
      an important factor predicting IAC-related vascular events.
CI  - Copyright (c) 2018 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Dalvin, Lauren A
AU  - Dalvin LA
AD  - Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,
      Philadelphia, Pennsylvania; Department of Ophthalmology, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Ancona-Lezama, David
AU  - Ancona-Lezama D
AD  - Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,
      Philadelphia, Pennsylvania.
FAU - Lucio-Alvarez, J Antonio
AU  - Lucio-Alvarez JA
AD  - Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,
      Philadelphia, Pennsylvania.
FAU - Masoomian, Babak
AU  - Masoomian B
AD  - Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,
      Philadelphia, Pennsylvania.
FAU - Jabbour, Pascal
AU  - Jabbour P
AD  - Department of Endovascular Neurosurgery, Thomas Jefferson University,
      Philadelphia, Pennsylvania.
FAU - Shields, Carol L
AU  - Shields CL
AD  - Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,
      Philadelphia, Pennsylvania. Electronic address: carolshields@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20180618
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
EIN - Ophthalmology. 2019 Jan;126(1):176-177. PMID: 30577913
EDAT- 2018/06/21 06:00
MHDA- 2018/06/21 06:00
CRDT- 2018/06/21 06:00
PHST- 2018/02/25 00:00 [received]
PHST- 2018/04/18 00:00 [revised]
PHST- 2018/05/09 00:00 [accepted]
PHST- 2018/06/21 06:00 [pubmed]
PHST- 2018/06/21 06:00 [medline]
PHST- 2018/06/21 06:00 [entrez]
AID - S0161-6420(18)30560-8 [pii]
AID - 10.1016/j.ophtha.2018.05.013 [doi]
PST - ppublish
SO  - Ophthalmology. 2018 Nov;125(11):1803-1811. doi: 10.1016/j.ophtha.2018.05.013.
      Epub 2018 Jun 18.