Intensive fundus screenings reduces need for enucleation

Intensive fundus screening in retinoblastoma patients decreases the need for enucleation and external beam radiation (EBRT), according to a study published in Eye.

The investigation, led by Dr P.R. Rothschild, Department of Ocular Oncology, Institut Curie, Paris, France, analysed the fundus examination results of 547 retinoblastoma patients between January 1995 and December 2004. Fundus exams were performed on children shortly after birth. All patients had a positive family history of retinoblastoma and underwent fundus screening under general anaesthesia.

Familial retinoblastoma cases were retrospectively placed into a 'screened' group and a 'non-screened' group (NS). The screened group were classified as intensively screened (IS) or non-intensively screened (NIS). The Fisher exact test was used to compare categorical variables between groups. The Kruskal-Wallis test was also used to compare continuous variables.

Of the 547 retinoblastoma patients included in the study, 59 were identified as familial cases. The NS group contained 20 patients, the S group consisted of 23 and the IS group had 16 patients.

The number of children who experienced enucleation was 13 for the NS group, 2 for the S group and 0 for the IS group. External beam radiation (EBRT) was completed in 6 of the NS children, 0 in the S group and 2 in the IS group.

Visual acuity and chemotherapy burden were not significantly different when compared between the groups. Intensive fundus screening reduced the need for enucleation and EBRT in children. The study recommends the referral of children with retinoblastoma for genetic counselling and sufficient fundus screening.