Long-term Visual Acuity, Strabismus and Nystagmus Outcomes Following Multimodality Treatment in Group D Retinoblastoma Eyes

Abstract Purpose To analyse the long-term visual acuity, strabismus and nystagmus outcomes in Group D retinoblastoma following multimodality treatments in a national retinoblastoma referral centre. Design Retrospective interventional case series. Methods A 13-year retrospective chart review of Group D eyes treated initially with intravenous chemotherapy (IVC) and followed-up for at least 1 year from last treatment. Risk factors for final visual acuity (VA) were analysed, and rate of strabismus and nystagmus at last follow-up visit were calculated. Results One hundred and four Group D eyes (92 patients) presented to our centre during the study period, of which 32 (27 patients) met the inclusion criteria. Following IVC (vincristine, etoposide and carboplatin), adjuvant treatments included intra-ophthalmic artery chemotherapy in 5 (16%) eyes, plaque brachytherapy in 5 (16%), transpupillary thermotherapy (TTT) in 18 (56%) and cryotherapy in 24 (75%) eyes. On last examination, 64.41 ± 6.76 months from presentation, mean final VA was 20/283 (logMAR equivalent of 1.15±0.15). On univariate analysis, presentation age, foveal retinoblastoma (at initial examination), use of TTT and tumour-foveola distance (at last visit) were found to be significant risk factors for worse VA (p