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de Bloeme CM, van Elst S, Galluzzi P, Jansen RW, de Haan J, Göricke S, Moll AC, Bot JCJ, Munier FL, Beck-Popovic M, Puccinelli F, Aerts I, Hadjistilianou T, Sirin S, Koob M, Brisse HJ, Cardoen L, Maeder P, de Jong MC, de Graaf P. MR Imaging of Adverse Effects and Ocular Growth Decline after Selective Intra-Arterial Chemotherapy for Retinoblastoma. Cancers (Basel) 2024; 16:1899. [PMID: 38791976 DOI: 10.3390/cancers16101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
This retrospective multicenter study examines therapy-induced orbital and ocular MRI findings in retinoblastoma patients following selective intra-arterial chemotherapy (SIAC) and quantifies the impact of SIAC on ocular and optic nerve growth. Patients were selected based on medical chart review, with inclusion criteria requiring the availability of posttreatment MR imaging encompassing T2-weighted and T1-weighted images (pre- and post-intravenous gadolinium administration). Qualitative features and quantitative measurements were independently scored by experienced radiologists, with deep learning segmentation aiding total eye volume assessment. Eyes were categorized into three groups: eyes receiving SIAC (Rb-SIAC), eyes treated with other eye-saving methods (Rb-control), and healthy eyes. The most prevalent adverse effects post-SIAC were inflammatory and vascular features, with therapy-induced contrast enhancement observed in the intraorbital optic nerve segment in 6% of patients. Quantitative analysis revealed significant growth arrest in Rb-SIAC eyes, particularly when treatment commenced ≤ 12 months of age. Optic nerve atrophy was a significant complication in Rb-SIAC eyes. In conclusion, this study highlights the vascular and inflammatory adverse effects observed post-SIAC in retinoblastoma patients and demonstrates a negative impact on eye and optic nerve growth, particularly in children treated ≤ 12 months of age, providing crucial insights for clinical management and future research.
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Affiliation(s)
- Christiaan M de Bloeme
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Sabien van Elst
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Paolo Galluzzi
- Department of Neuroimaging Unit, Siena University Hospital, 53100 Siena, Italy
| | - Robin W Jansen
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Joeka de Haan
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
| | - Sophia Göricke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45147 Essen, Germany
| | - Annette C Moll
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Joseph C J Bot
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Francis L Munier
- Unit of Pediatric Ocular Oncology, Jules-Gonin Eye Hospital, University of Lausanne, 1015 Lausanne, Switzerland
| | - Maja Beck-Popovic
- Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - Francesco Puccinelli
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - Isabelle Aerts
- Pediatricic Department, Institut Curie, PSL Research University, 75005 Paris, France
| | - Theodora Hadjistilianou
- Unit of Ophthalmology and Referral Center for Retinoblastoma, Department of Surgery, Policlinico "Santa Maria alle Scotte", 53100 Siena, Italy
| | - Selma Sirin
- Department of Diagnostic Imaging, University Children's Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
| | - Mériam Koob
- Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - Hervé J Brisse
- Imaging Department, Institut Curie, Paris University, 75005 Paris, France
| | - Liesbeth Cardoen
- Imaging Department, Institut Curie, Paris University, 75005 Paris, France
| | - Philippe Maeder
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - Marcus C de Jong
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Pim de Graaf
- Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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Girolamo MM, Hadjistilianou T, Lembo A, Salvoldi F, Serafino M, Barchitta M, Menicacci C, De Francesco S, Nucci P. Unusual anterior and posterior segment features of coats disease. Eur J Ophthalmol 2024; 34:419-424. [PMID: 37439027 DOI: 10.1177/11206721231188996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
PURPOSE To report the clinical course and management of unusual anterior and posterior segment features of Coats disease and their relation to the age of the patients to increase the awareness towards these rare clinical features rarely described in the current literature. METHODS A retrospective descriptive review of 45 eyes of 45 patients affected by Coats disease was conducted at the Retinoblastoma Referral Center and Ophthalmology Unit of the University of Siena in Italy analyzing data from 2000 to 2022. Medical records and images were revised to find some cases presenting unusual anterior and posterior segment features in patients affected by Coats disease.We identified therefore 4 unusual clinical conditions: retinal macrocysts, anterior chamber cholesterolosis, fovea-sparing Coats disease and secondary vasoproliferative tumor. RESULTS Two patients presented with retinal macrocyst (2/45 = 4.4%), one with anterior chamber cholesterolosis (1/45 = 2.2%), two with fovea sparing Coats disease (2/45 = 4.4%) and one with vasoproliferative tumor associated (1/45 = 2.2%) for a total of six (6/45 = 13.3%) patients manifesting unusual anterior or posterior segment features in Coats disease. CONCLUSION Unusual anterior and posterior segment features of Coats disease such as retinal macrocyst and anterior chamber cholesterolosis have been more frequently reported in younger children while fovea-sparing and vasoproliferative tumors have been more commonly described in older patients. Age is then a strong prognostic marker which allows to distinguish two different phenotypes of Coats disease: patients younger and older than 3 years old with more aggressive and milder phenotype respectively.
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Affiliation(s)
- Matteo Maria Girolamo
- Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, OcularOncology - Retinoblastoma Referral Center, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Theodora Hadjistilianou
- Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, OcularOncology - Retinoblastoma Referral Center, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Andrea Lembo
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Milan, Italy
| | - Federica Salvoldi
- Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, OcularOncology - Retinoblastoma Referral Center, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Massimiliano Serafino
- Department of Neuroscience, Unit of Ophthalmology, Istituto Giannina Gaslini, Genoa, Italy
| | - Matteo Barchitta
- Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, OcularOncology - Retinoblastoma Referral Center, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Cristina Menicacci
- Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, OcularOncology - Retinoblastoma Referral Center, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Sonia De Francesco
- Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, OcularOncology - Retinoblastoma Referral Center, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Paolo Nucci
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Milan, Italy
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Doddato G, Fabbiani A, Fallerini C, Bruttini M, Hadjistilianou T, Landi M, Coradeschi C, Grosso S, Tomasini B, Mencarelli MA, Renieri A, Ariani F. Corrigendum: Spondyloocular syndrome: A novel XYLT2 variant with description of the neonatal phenotype. Front Genet 2023; 14:1143795. [PMID: 36761000 PMCID: PMC9905838 DOI: 10.3389/fgene.2023.1143795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fgene.2021.761264.].
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Affiliation(s)
- Gabriella Doddato
- Medical Genetics, University of Siena, Siena, Tuscany, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Tuscany, Italy
| | - Alessandra Fabbiani
- Medical Genetics, University of Siena, Siena, Tuscany, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Tuscany, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | - Chiara Fallerini
- Medical Genetics, University of Siena, Siena, Tuscany, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Tuscany, Italy
| | - Mirella Bruttini
- Medical Genetics, University of Siena, Siena, Tuscany, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Tuscany, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | - Theodora Hadjistilianou
- Ophthalmological Science and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | - Martino Landi
- Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | - Caterina Coradeschi
- Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | - Salvatore Grosso
- Pediatria, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | - Barbara Tomasini
- Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | | | - Alessandra Renieri
- Medical Genetics, University of Siena, Siena, Tuscany, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Tuscany, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy
| | - Francesca Ariani
- Medical Genetics, University of Siena, Siena, Tuscany, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Tuscany, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Tuscany, Italy,*Correspondence: Francesca Ariani,
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Abdulrahaman AA, Abouelnaga S, Ademola-Popoola DS, Adio A, Afifi MA, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Akinsete A, Al Harby L, Al Mesfer S, Al Ani MH, Alarcón Portabella S, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad CE, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amankwaa-Frempong D, Amiruddin PO, Armytasari I, Astbury NJ, Atalay HT, Ataseven E, Atchaneeyasakul LO, Atsiaya R, Autrata R, Balaguer J, Balayeva R, Barranco H, Bartoszek P, Bartuma K, Bascaran C, Bechrakis NE, Beck Popovic M, Begimkulova AS, Benmiloud S, Berete RC, Berry JL, Bhaduri A, Bhat S, Bhattacharyya A, Biewald EM, Binkley E, Blum S, Bobrova N, Boldt H, Bonanomi MTBC, Bouda GC, Bouguila H, Brennan RC, Brichard BG, Buaboonnam J, Budiongo A, Burton MJ, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Caspi S, Cassoux N, Castela G, Castillo L, Català-Mora J, Cavieres I, Chandramohan A, Chantada GL, Chaudhry S, Chawla B, Chen W, Chiwanga FS, Chuluunbat T, Cieslik K, Clark A, Cockcroft RL, Comsa C, Correa Llano MG, Corson TW, Couitchere L, Cowan-Lyn KE, Csóka M, Dangboon W, Das A, Das P, Das S, Davanzo JM, Davidson A, De Francesco S, De Potter P, Quintero D K, Demirci H, Desjardins L, Díaz Coronado RY, Dimaras H, Dodgshun AJ, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Du Plessis J, Dudeja G, Eerme K, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elhaddad AM, Elhassan MMA, Elzembely MM, Ericksen C, Essuman VA, Evina TGA, Ezegwui IR, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Garcia JL, García Aldana D, Garcia Pacheco HN, Geel JA, Ghassemi F, Girón AV, Goenz MA, Gold AS, Goldberg H, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Gorfine M, Graells J, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Gupta V, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Muhammad H, Hassan S, Hassan S, Hautz W, Haydar H, Hederova S, Hessissen L, Hongeng S, Hordofa DF, Hubbard GB, Hummelen M, Husakova K, Hussein Al-Janabi AN, Ibanga A, Ida R, Ilic VR, Islamov Z, Jairaj V, Janjua T, Jeeva I, Ji X, Jo DH, Jones MM, Kabesha Amani TB, Kabore RL, Kaliki S, Kalinaki A, Kamsang P, Kantar M, Kapelushnik N, Kardava T, Kebudi R, Keomisy J, Kepak T, Ketteler P, Khan ZJ, Khaqan HA, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivela TT, Klett A, Koç I, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lam GC, Larson SA, Latinović S, Laurenti KD, Lavy Y, Lavric Groznik A, Leverant AA, Li C, Li K, Limbu B, Liu CH, Quah B, López JP, Lukamba RM, Luna-Fineman S, Lutfi D, Lysytsia L, Madgar S, Magrath GN, Mahajan A, Maitra P, Maka E, Makimbetov EK, Maktabi A, Maldonado C, Mallipatna A, Manudhane R, Manzhuova L, Martín-Begue N, Masud S, Matende IO, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Mehrvar A, Mengesha AA, Menon V, Mercado GJV, Mets MB, Midena E, Miller A, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KIM, Munier FL, Murray TG, Musa KO, Mushtaq A, Musika AA, Mustak H, Mustapha T, Muyen OM, Myezo KH, Naidu G, Naidu N, Nair AG, Natarajan S, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ng Y, Nikitovic M, Nkanga ED, Nkumbe HE, Numbi MN, Nummi K, Nuruddin M, Nyaywa M, Nyirenda C, Obono-Obiang G, Oliver SCN, Oporto J, Ortega-Hernández M, Oscar AH, Ossandon D, Pagarra H, Paintsil V, Paiva L, Palanivelu MS, Papyan R, Parrozzani R, Pascual Morales CR, Paton KE, Pe'er J, Peralta Calvo J, Perić S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov V, Ponce J, Qadir AO, Qayyum S, Qian J, Refaeli D, Rahman A, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Randhawa JK, Randrianarisoa HL, Raobela L, Rashid R, Reddy M, Renner LA, Reynders D, Ribadu D, Ritter-Sovinz P, Rogowska A, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sanchez Orozco AJ, Sayalith P, Scanlan TA, Schlüter S, Schwab C, Sedaghat A, Seth R, Sgroi M, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shields CL, Sia D, Siddiqui SN, Sidi cheikh S, Silva S, Singh AD, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Steinberg DM, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tang J, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Teh KH, Tehuteru ES, Teixeira LF, Tekavcic Pompe M, Thawaba ADM, Theophile T, Toledano H, Trang DL, Traoré F, Tripathy D, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, Valente P, van Hoefen Wijsard M, Vasquez Anchaya JK, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Villegas VM, Vishnevskia-Dai V, Waddell K, Wali AH, Wang YZ, Wangtiraumnuay N, Wetter J, Widiarti W, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wong ES, Wongwai P, Wu SQ, Xiang D, Xiao Y, Xu B, Xue K, Yaghy A, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yee RI, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang Y, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries. The Lancet Global Health 2022; 10:e1128-e1140. [PMID: 35839812 PMCID: PMC9397647 DOI: 10.1016/s2214-109x(22)00250-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. Methods We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. Findings The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). Interpretation This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes. Funding Queen Elizabeth Diamond Jubilee Trust.
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Doddato G, Fabbiani A, Fallerini C, Bruttini M, Hadjistilianou T, Landi M, Coradeschi C, Grosso S, Tomasini B, Mencarelli MA, Renieri A, Ariani F. Spondyloocular Syndrome: A Novel XYLT2 Variant with Description of the Neonatal Phenotype. Front Genet 2021; 12:761264. [PMID: 34925453 PMCID: PMC8680350 DOI: 10.3389/fgene.2021.761264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Spondyloocular syndrome (SOS) is a skeletal disorder caused by pathogenic variants in XYLT2 gene encoding a xylotransferase involved in the biosynthesis of proteoglycans. This condition, with autosomal recessive inheritance, has a high phenotypic variability. It is characterized by bone abnormalities (osteoporosis, fractures), eye and cardiac defects, hearing impairment, and varying degrees of developmental delay. Until now only 20 mutated individuals have been reported worldwide. Here, we describe two siblings from consanguineous healthy parents in which a novel homozygous frameshift variant c.1586dup p(Thr530Hisfs*) in the XYLT2 gene was detected by exome sequencing (ES). The first patient (9 years) presented short stature with skeletal defects, long face, hearing loss and cataract. The second patient, evaluated at a few days of life, showed macrosomia, diffuse hypertrichosis on the back, overabundant skin in the retronucal area, flattened facial profile with drooping cheeks, elongated eyelid rims, wide and flattened nasal bridge and turned down corners of the mouth. During the prenatal period, high nuchal translucency and intestinal hyperechogenicity were observed at ultrasound. In conclusion, these two siblings with a novel pathogenic variant in XYLT2 further expand the clinical and mutational spectrum of SOS.
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Affiliation(s)
- Gabriella Doddato
- Medical Genetics, University of Siena, Siena, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Alessandra Fabbiani
- Medical Genetics, University of Siena, Siena, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Chiara Fallerini
- Medical Genetics, University of Siena, Siena, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Mirella Bruttini
- Medical Genetics, University of Siena, Siena, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Theodora Hadjistilianou
- Ophthalmological Science and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Martino Landi
- Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Caterina Coradeschi
- Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Salvatore Grosso
- Pediatria, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Barbara Tomasini
- Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Alessandra Renieri
- Medical Genetics, University of Siena, Siena, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Francesca Ariani
- Medical Genetics, University of Siena, Siena, Italy,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy,*Correspondence: Francesca Ariani,
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Fruschelli M, Lorusso N, Hadjistilianou T, Mencarelli MA, Bruttini M, Renieri A, Mandalà M, Di Maggio A. Novel retinal finding in a patient with 4q12 deletion. Ophthalmic Genet 2021; 43:120-122. [PMID: 34551660 DOI: 10.1080/13816810.2021.1978102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Chromosome 4q deletions are rare disorders phenotypically characterized by several features. The most commonly described ocular abnormalities include unilateral microphthalmia with bilateral colobomata, blue sclerae with pigmented retinal clumps, hypermetropia, and a divergent squint. PURPOSE To report a case of 4q12 deletion with a singular retinal feature. MATERIALS AND METHODS Case report. RESULTS A 20-year-old Caucasian female with a history of poliosis, progressive appearance of small areas of skin depigmentation along trunk and limbs since birth and diagnosis of learning deficit was referred for a complete ocular examination. The genetic counseling showed microdeletion in the 4q12 region. An audiometric test was performed, showing a progressive bilateral neurosensorial hypoacusia. Ocular examination showed the presence of multifocal, tiny, whitish deposits in the posterior pole. Multimodal imaging defined the lesions as small elevations of the retinal pigment epithelium with slight hyper-autofluorescence and staining in the late phase of fluoresceine angiography (FA). Visual acuity was 20/20. The retinal findings did not change during the three-month follow-up. CONCLUSIONS Although the findings herein reported have never been described before in patients affected by 4q12 mutations, we do not exclude that they could represent a manifestation of the peculiar genetic asset of the patient, related to dysfunction in pigment epithelium/neuroretinal metabolic activity.
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Affiliation(s)
- Mario Fruschelli
- Dipartimento di Scienze Mediche Chirurgiche e Neuroscienze, University of Siena, Siena, Italy
| | - Nicola Lorusso
- Graduate School of Ophthalmology, University of Siena, Siena, Italy
| | - Theodora Hadjistilianou
- Dipartimento di Scienze Mediche Chirurgiche e Neuroscienze, University of Siena, Siena, Italy
| | | | - Mirella Bruttini
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy.,Medical Genetics, University of Siena, Siena, Italy.,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Alessandra Renieri
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy.,Medical Genetics, University of Siena, Siena, Italy.,Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marco Mandalà
- Dipartimento di Scienze Mediche Chirurgiche e Neuroscienze, University of Siena, Siena, Italy
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Privitera F, Calonaci A, Doddato G, Papa FT, Baldassarri M, Pinto AM, Mari F, Longo I, Caini M, Galimberti D, Hadjistilianou T, De Francesco S, Renieri A, Ariani F. 13q Deletion Syndrome Involving RB1: Characterization of a New Minimal Critical Region for Psychomotor Delay. Genes (Basel) 2021; 12:genes12091318. [PMID: 34573300 PMCID: PMC8471443 DOI: 10.3390/genes12091318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022] Open
Abstract
Retinoblastoma (RB) is an ocular tumor of the pediatric age caused by biallelic inactivation of the RB1 gene (13q14). About 10% of cases are due to gross-sized molecular deletions. The deletions can involve the surrounding genes delineating a contiguous gene syndrome characterized by RB, developmental anomalies, and peculiar facial dysmorphisms. Overlapping deletions previously found by traditional and/or molecular cytogenetic analysis allowed to define some critical regions for intellectual disability (ID) and multiple congenital anomalies, with key candidate genes. In the present study, using array-CGH, we characterized seven new patients with interstitial 13q deletion involving RB1. Among these cases, three patients with medium or large 13q deletions did not present psychomotor delay. This allowed defining a minimal critical region for ID that excludes the previously suggested candidate genes (HTR2A, NUFIP1, PCDH8, and PCDH17). The region contains 36 genes including NBEA, which emerged as the candidate gene associated with developmental delay. In addition, MAB21L1, DCLK1, EXOSC8, and SPART haploinsufficiency might contribute to the observed impaired neurodevelopmental phenotype. In conclusion, this study adds important novelties to the 13q deletion syndrome, although further studies are needed to better characterize the contribution of different genes and to understand how the haploinsufficiency of this region can determine ID.
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Affiliation(s)
- Flavia Privitera
- Medical Genetics, University of Siena, 53100 Siena, Italy; (F.P.); (G.D.); (F.T.P.); (M.B.); (F.M.); (A.R.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Arianna Calonaci
- Unit of Pediatrics, Department of Maternal, Newborn and Child Health, Azienda Ospedaliera Universitaria Senese, Policlinico ‘Santa Maria alle Scotte’, 53100 Siena, Italy; (A.C.); (M.C.); (D.G.)
| | - Gabriella Doddato
- Medical Genetics, University of Siena, 53100 Siena, Italy; (F.P.); (G.D.); (F.T.P.); (M.B.); (F.M.); (A.R.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Filomena Tiziana Papa
- Medical Genetics, University of Siena, 53100 Siena, Italy; (F.P.); (G.D.); (F.T.P.); (M.B.); (F.M.); (A.R.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Margherita Baldassarri
- Medical Genetics, University of Siena, 53100 Siena, Italy; (F.P.); (G.D.); (F.T.P.); (M.B.); (F.M.); (A.R.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Anna Maria Pinto
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy; (A.M.P.); (I.L.)
| | - Francesca Mari
- Medical Genetics, University of Siena, 53100 Siena, Italy; (F.P.); (G.D.); (F.T.P.); (M.B.); (F.M.); (A.R.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy; (A.M.P.); (I.L.)
| | - Ilaria Longo
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy; (A.M.P.); (I.L.)
| | - Mauro Caini
- Unit of Pediatrics, Department of Maternal, Newborn and Child Health, Azienda Ospedaliera Universitaria Senese, Policlinico ‘Santa Maria alle Scotte’, 53100 Siena, Italy; (A.C.); (M.C.); (D.G.)
| | - Daniela Galimberti
- Unit of Pediatrics, Department of Maternal, Newborn and Child Health, Azienda Ospedaliera Universitaria Senese, Policlinico ‘Santa Maria alle Scotte’, 53100 Siena, Italy; (A.C.); (M.C.); (D.G.)
| | - Theodora Hadjistilianou
- Unit of Ophthalmology and Retinoblastoma Referral Center, Department of Surgery, University of Siena, Policlinico ‘Santa Maria alle Scotte’, 53100 Siena, Italy; (T.H.); (S.D.F.)
| | - Sonia De Francesco
- Unit of Ophthalmology and Retinoblastoma Referral Center, Department of Surgery, University of Siena, Policlinico ‘Santa Maria alle Scotte’, 53100 Siena, Italy; (T.H.); (S.D.F.)
| | - Alessandra Renieri
- Medical Genetics, University of Siena, 53100 Siena, Italy; (F.P.); (G.D.); (F.T.P.); (M.B.); (F.M.); (A.R.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy; (A.M.P.); (I.L.)
| | - Francesca Ariani
- Medical Genetics, University of Siena, 53100 Siena, Italy; (F.P.); (G.D.); (F.T.P.); (M.B.); (F.M.); (A.R.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy; (A.M.P.); (I.L.)
- Correspondence: ; Tel.: +39-057-723-3303
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Miracco C, Toti P, Gelmi MC, Aversa S, Baldino G, Galluzzi P, De Francesco S, Petrelli F, Sorrentino E, Belmonte G, Galimberti D, Bracco S, Hadjistilianou T. Retinoblastoma Is Characterized by a Cold, CD8+ Cell Poor, PD-L1- Microenvironment, Which Turns Into Hot, CD8+ Cell Rich, PD-L1+ After Chemotherapy. Invest Ophthalmol Vis Sci 2021; 62:6. [PMID: 33538768 PMCID: PMC7862737 DOI: 10.1167/iovs.62.2.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose To investigate the impact of chemotherapy (CHT) on human retinoblastoma (RB) tumor microenvironment (TME). Cases and Methods Ninety-four RBs were studied, including 44 primary RBs treated by upfront surgery (Group 1) and 50 primary RBs enucleated after CHT (CHT), either intra-arterial (IAC; Group 2, 33 cases) or systemic (S-CHT; Group 3, 17 cases). Conventional and multiplexed immunohistochemistry were performed to make quantitative comparisons among the three groups, for the following parameters: tumor-infiltrating inflammatory cells (TI-ICs); programmed cell death protein 1 (PD-1) positive TI-ICs; Ki67 proliferation index; gliosis; PD-1 ligand (PD-L1) protein expression; vessel number. We also correlated these TME factors with the presence of histological high-risk factors (HHRF+) and RB anaplasia grade (AG). Results After CHT, a decrease in both RB burden and Ki67 positivity was observed. In parallel, most subsets of TI-ICs, PD-1+ TI-ICs, gliosis, and PD-L1 protein expression significantly increased (P < 0.001, P = 0.02, P < 0.001, respectively). Vessel number did not significantly vary. Age, HHRFs+ and AG were significantly different between primary and chemoreduced RBs (P < 0.001, P = 0.006, P = 0.001, respectively) and were correlated with most TME factors. Conclusions CHT modulates host antitumor immunity by reorienting the RB TME from anergic into an active, CD8+, PD-L1+ hot state. Furthermore, some clinicopathological characteristics of RB correlate with several factors of TME. Our study adds data in favor of the possibility of a new therapeutic scenario in human RB.
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Affiliation(s)
- Clelia Miracco
- Department of Medicine, Surgery and Neuroscience, Pathological Anatomy Section, University Hospital of Siena, Siena, Italy
| | - Paolo Toti
- Department of Medicine, Surgery and Neuroscience, Pathological Anatomy Section, University Hospital of Siena, Siena, Italy
| | - Maria Chiara Gelmi
- Department of Medicine, Surgery and Neuroscience, Ophthalmology Unit, University Hospital of Siena, Siena, Italy
| | - Sara Aversa
- Department of Medicine, Surgery and Neuroscience, Pathological Anatomy Section, University Hospital of Siena, Siena, Italy
| | - Gennaro Baldino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Paolo Galluzzi
- Department of Medicine, Surgery and Neuroscience, Unit of Neuroimaging and Neurointervention, University Hospital of Siena, Siena, Italy
| | - Sonia De Francesco
- Department of Medicine, Surgery and Neuroscience, Ophthalmology Unit, University Hospital of Siena, Siena, Italy
| | - Federica Petrelli
- Department of Medicine, Surgery and Neuroscience, Pathological Anatomy Section, University Hospital of Siena, Siena, Italy
| | - Ester Sorrentino
- Department of Medicine, Surgery and Neuroscience, Pathological Anatomy Section, University Hospital of Siena, Siena, Italy
| | - Giuseppe Belmonte
- Department of Medicine, Surgery and Neuroscience, Pathological Anatomy Section, University Hospital of Siena, Siena, Italy
| | - Daniela Galimberti
- Department of Maternal, Newborn and Child Health, Unit of Pediatrics, University Hospital of Siena, Siena, Italy
| | - Sandra Bracco
- Department of Medicine, Surgery and Neuroscience, Unit of Neuroimaging and Neurointervention, University Hospital of Siena, Siena, Italy
| | - Theodora Hadjistilianou
- Department of Medicine, Surgery and Neuroscience, Ophthalmology Unit, University Hospital of Siena, Siena, Italy
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9
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Menicacci C, Al-Jamal RT, De Francesco S, Barchitta M, Girolamo M, Di Maggio A, Hadjistilianou T. Very late orbital recurrence of choroidal melanoma four decades post enucleation. Eur J Ophthalmol 2021; 32:NP88-NP93. [PMID: 33706580 DOI: 10.1177/11206721211001266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Orbital recurrence of malignant choroidal melanoma is quite uncommon, occurring in about 3% of patients undergoing enucleation for large tumors. Orbital recurrences after more than 10 years from enucleation are even rarer. In literature, only few reports described orbital recurrence that occurred between 10 and 40 years after primary diagnosis. Herein we report a very late choroidal melanoma recurrence, 40 years post enucleation, of a 52 year-old female who had undergone left enucleation at the age of 12. She presented to our clinic for consultation in 2017, complaining of difficulty to contain the prosthesis, as well as, presence of small pigmented palpable nodules inferiorly in her anophthalmic socket. The patient was not aware of the medical condition which had lead to the enucleation. We requested her medical reports and detailed history through her family. We realized after reviewing her charts 40 years back, that her enucleation was due to malignant choroidal melanoma (CMM). Full screening was performed. After magnetic resonance imaging (MRI), that showed the presence of nodular masses in the anophthalmic socket, an excisional biopsy was performed. Histopathology confirmed the diagnosis of CMM (epithelioid and spindle cell type), supporting the hypothesis that residual melanoma cells may remain clinically dormant for long periods, even for decades. A literature review was performed in order to review similar cases and to understand and discuss multiple factors, which may explain this extremely delayed recurrence. To the best of our knowledge, this is the third case to be reported in the literature.
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Affiliation(s)
- Cristina Menicacci
- Unit of Ophthalmology, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Rana'a T Al-Jamal
- Ocular Oncology Service, Helsinki University Central Hospital, Helsinki, Finland
| | - Sonia De Francesco
- Unit of Ophthalmology, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Matteo Barchitta
- Unit of Ophthalmology, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Matteo Girolamo
- Unit of Ophthalmology, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Alessandro Di Maggio
- Unit of Ophthalmology, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Theodora Hadjistilianou
- Unit of Ophthalmology, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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10
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Jansen RW, de Bloeme CM, Brisse HJ, Galluzzi P, Cardoen L, Göricke S, Maeder P, Cassoux N, Gauthier A, Schlueter S, Hadjistilianou T, Munier FL, Castelijns JA, van der Valk P, Moll AC, de Jong MC, de Graaf P. MR Imaging Features to Differentiate Retinoblastoma from Coats' Disease and Persistent Fetal Vasculature. Cancers (Basel) 2020; 12:cancers12123592. [PMID: 33266342 PMCID: PMC7760210 DOI: 10.3390/cancers12123592] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Retinoblastoma is a rare cancer that develops in the retina of children. Accurate differentiation between retinoblastoma and conditions that show similarities with retinoblastoma (pseudoretinoblastoma or retinoblastoma mimickers) is vital for guiding treatment. The most common pseudoretinoblastoma conditions are Coats’ disease and persistent fetal vasculature (PFV). In this study, we aimed to improve pretreatment differentiation between these diseases on MR imaging. We compared pre-treatment MR images of retinoblastoma, Coats’ disease and PFV on 20 predefined MR imaging features. An assessment strategy was proposed incorporating MR imaging features that best differentiate retinoblastoma from pseudoretinoblastoma, including three newly identified MR imaging features. Abstract Retinoblastoma mimickers, or pseudoretinoblastoma, are conditions that show similarities with the pediatric cancer retinoblastoma. However, false-positive retinoblastoma diagnosis can cause mistreatment, while false-negative diagnosis can cause life-threatening treatment delay. The purpose of this study is to identify the MR imaging features that best differentiate between retinoblastoma and the most common pseudoretinoblastoma diagnoses: Coats’ disease and persistent fetal vasculature (PFV). Here, six expert radiologists performed retrospective assessments (blinded for diagnosis) of MR images of patients with a final diagnosis based on histopathology or clinical follow-up. Associations between 20 predefined imaging features and diagnosis were assessed with exact tests corrected for multiple hypothesis testing. Sixty-six patients were included, of which 33 (50%) were retinoblastoma and 33 (50%) pseudoretinoblastoma patients. A larger eye size, vitreous seeding, and sharp-V-shaped retinal detachment were almost exclusively found in retinoblastoma (p < 0.001–0.022, specificity 93–97%). Features that were almost exclusively found in pseudoretinoblastoma included smaller eye size, ciliary/lens deformations, optic nerve atrophy, a central stalk between optic disc and lens, Y-shaped retinal detachment, and absence of calcifications (p < 0.001–0.022, specificity 91–100%). Additionally, three newly identified imaging features were exclusively present in pseudoretinoblastoma: intraretinal macrocysts (p < 0.001, 38% [9/24] in Coats’ disease and 20% [2/10] in PFV), contrast enhancement outside the solid lesion (p < 0.001, 30% [7/23] in Coats’ disease and 57% [4/7] in PFV), and enhancing subfoveal nodules (38% [9/24] in Coats’ disease). An assessment strategy was proposed for MR imaging differentiation between retinoblastoma and pseudoretinoblastoma, including three newly identified differentiating MR imaging features.
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Affiliation(s)
- Robin W. Jansen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081HV Amsterdam, The Netherlands; (R.W.J.); (C.M.d.B.); (J.A.C.); (M.C.d.J.)
| | - Christiaan M. de Bloeme
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081HV Amsterdam, The Netherlands; (R.W.J.); (C.M.d.B.); (J.A.C.); (M.C.d.J.)
| | - Hervé J. Brisse
- Department of Radiology, Institut Curie, Paris University, 75005 Paris, France; (H.J.B.); (L.C.)
| | - Paolo Galluzzi
- Department of Neuroimaging and Neurointervention, Siena University Hospital, 53100 Siena, Italy;
| | - Liesbeth Cardoen
- Department of Radiology, Institut Curie, Paris University, 75005 Paris, France; (H.J.B.); (L.C.)
| | - Sophia Göricke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45147 Essen, Germany;
| | - Philippe Maeder
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011 Lausanne, Switzerland;
| | - Nathalie Cassoux
- Department of Ocular Oncology, Institut Curie, Paris University, 75005 Paris, France;
| | - Arnaud Gauthier
- Department of Pathology, Institut Curie, Paris University, 75005 Paris, France;
| | - Sabrina Schlueter
- Department of Ophthalmology, University Hospital Essen, 45147 Essen, Germany;
| | | | - Francis L. Munier
- Department of Ophthalmology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011 Lausanne, Switzerland;
- Hôpital Ophtalmique Jules-Gonin, 1004 Lausanne, Switzerland
| | - Jonas A. Castelijns
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081HV Amsterdam, The Netherlands; (R.W.J.); (C.M.d.B.); (J.A.C.); (M.C.d.J.)
| | - Paul van der Valk
- Department of Pathology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, 1081HV Amsterdam, The Netherlands;
| | - Annette C. Moll
- Department of Ophthalmology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, 1081HV Amsterdam, The Netherlands;
| | - Marcus C. de Jong
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081HV Amsterdam, The Netherlands; (R.W.J.); (C.M.d.B.); (J.A.C.); (M.C.d.J.)
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081HV Amsterdam, The Netherlands; (R.W.J.); (C.M.d.B.); (J.A.C.); (M.C.d.J.)
- Correspondence:
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Girolamo MM, De Francesco S, Salvoldi F, Barchitta M, Menicacci C, Hadjistilianou T. Fovea-sparing coats disease: A rare clinical entity. Eur J Ophthalmol 2020; 31:3405-3410. [PMID: 33222523 DOI: 10.1177/1120672120974289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the rarity, clinical features and management of Coats disease characterized by fovea-sparing enhancing the importance of pediatric retinal screening and early management to maintain a good visual acuity. METHODS Retrospective analysis of approximately 40 patients affected by Coats disease between 2000 and 2020 at the Retinoblastoma Referral Center and Ophthalmology unit of the University of Siena in Italy. RESULTS Two patients with fovea sparing Coats disease were included. Both presented an extrafoveal Coats disease (stage 2A by Shields classification) when they were 5 and 6 years old respectively.They had no anterior findings and a presenting visual acuity of 20/20 reflecting the early stage and a milder phenotype of the disease which are indeed more likely to be found in patients older than 3 years at presentation.Both presented telangiectasia and retinal exudation in the affected eye. Standard Argon laser photocoagulation and subsequently Cryotherapy were performed in the telangiectatic retinal periphery of both patients obtaining an excellent control and regression of the disease. CONCLUSIONS Careful pediatric retinal screening and early management are crucial to ensure a good visual prognosis in such an early feature of Coats disease as fovea sparing since this condition unfortunately tends to recall the physician's attention in more advanced stages.Due to the extremely poor number of articles regarding such a rare feature of Coats disease like fovea sparing, we report our experience.
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Affiliation(s)
- Matteo Maria Girolamo
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Sonia De Francesco
- Retinoblastoma Tertiary Referral Center, University of Siena, Siena, Italy
| | - Federica Salvoldi
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Matteo Barchitta
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Cristina Menicacci
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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Fabian ID, Stacey AW, Foster A, Kivelä TT, Munier FL, Keren-Froim N, Gomel N, Cassoux N, Sagoo MS, Reddy MA, Harby LA, Zondervan M, Bascaran C, Abdallah E, Abdullahi SU, Boubacar SA, Ademola-Popoola DS, Adio A, Aghaji AE, Portabella SA, Alfa Bio AI, Ali AM, Alia DB, All-Eriksson C, Almeida AA, Alsawidi KM, Antonino R, Astbury NJ, Atsiaya R, Balaguer J, Balwierz W, Barranco H, Popovic MB, Benmiloud S, Guebessi NB, Berete RC, Biddulph SJ, Biewald EM, Blum S, Bobrova N, Boehme M, Bornfeld N, Bouda GC, Bouguila H, Boumedane A, Brichard BG, L MC, Castela G, Català-Mora J, Chantada GL, Chernodrinska VS, Chiwanga FS, Cieslik K, Comsa C, Correa Llano MG, Csóka M, Da Gama IV, Davidson A, Potter PD, Desjardins L, Dragomir MD, Bruyn MD, Kettani AE, Elbahi AM, Elgalaly D, Elhaddad AM, Ali Elhassan MM, Elzembely MM, Essuman VA, Evina TGA, Fasina O, Fernández-Teijeiro A, Gandiwa M, Aldana DG, Geel JA, Gizachew Z, Gregersen PA, Guedenon KM, Hadjistilianou T, Hassan S, Hederova S, Hessissen L, Hordofa DF, Hummlen M, Husakova K, Ida R, Ilic VR, Jenkinson H, Amani Kabesha TB, Kabore RL, Kalinaki A, Kapelushnik N, Kardava T, Kemilev PK, Kepak T, Khotenashvili Z, Klett A, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kyara A, Lachmann ES, Latinović S, Lecuona K, Lukamba RM, Lumbroso L, Lysytsia L, Maka E, Makan M, Manda C, Begue NM, Matende IO, Matua M, Mayet I, Mbumba FB, Mengesha AA, Midena E, Mndeme FG, Mohamedani AA, Moll AC, Moreira C, Msina MS, Msukwa G, Muma KI, Murgoi G, Musa KO, Mustak H, Muyen OM, Naidu G, Naumenko L, Ndoye Roth PA, Neroev V, Nikitovic M, Nkanga ED, Nkumbe H, Nyaywa M, Obono-Obiang G, Oguego NC, Olechowski A, Oscar AH, Osei-Bonsu P, Painter SL, Paintsil V, Paiva L, Papyan R, Parrozzani R, Parulekar M, Pawinska-Wasikowska K, Perić S, Philbert R, Pochop P, Polyakov VG, Pompe MT, Pons JJ, Raobela L, Renner LA, Reynders D, Ribadu D, Riheia MM, Ritter-Sovinz P, Saakyan S, Said AM, Román Pacheco SS, Scanlan TA, Schoeman J, Seregard S, Sherief ST, Cheikh SS, Silva S, Sorochynska T, Ssali G, Stathopoulos C, Kranjc BS, Stones DK, Svojgr K, Sylla F, Tamamyan G, Tandili A, Tateshi B, Theophile T, Traoré F, Tyau-Tyau H, Umar AB, Urbak SF, Ushakova TL, Valeina S, Hoefen Wijsard MV, Veleva-Krasteva NV, Viksnins M, Wackernagel W, Waddell K, Wade PD, Wali Nigeria AH, Wime AD, Dod CW, Yanga JM, Yarovaya VA, Yarovoy AA, Zein E, Sharabi S, Zhilyaeva K, Ziko OA, Bowman R. Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries. Br J Ophthalmol 2020; 105:1435-1443. [PMID: 32933936 DOI: 10.1136/bjophthalmol-2020-316613] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/28/2020] [Accepted: 08/17/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.
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Affiliation(s)
- Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK .,The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle, WA, US
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | | | - Nir Gomel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nathalie Cassoux
- Institut curie, université de Paris medicine Paris V Descartes, Paris, France
| | - Mandeep S Sagoo
- NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, UK
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Elhassan Abdallah
- Ophthalmology Department of Rabat, Mohammed V university, Rabat, Morocco
| | | | | | - Dupe S Ademola-Popoola
- University of Ilorin and University of IlorinTeaching Hospital, Ilorin, Kwara State, Nigeria
| | - Adedayo Adio
- Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Ada E Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | | | | | - Amany M Ali
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Donjeta B Alia
- University Hospital Center 'Mother Theresa', Tirana, Albania
| | | | | | | | | | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rose Atsiaya
- Light House For Christ Eye Center, Mombasa, Kenya
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland
| | - Honorio Barranco
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Maja Beck Popovic
- Unit of Pediatric Hematology-Oncology, University Hospital CHUV, Lausanne, Switzerland
| | - Sarra Benmiloud
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | | | - Rokia C Berete
- Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'ivoire
| | | | - Eva M Biewald
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Sharon Blum
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Nadia Bobrova
- The Filatov Institute of Eye diseases and Tissue Therapy, Odessa, Ukraine
| | - Marianna Boehme
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Norbert Bornfeld
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Gabrielle C Bouda
- Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Hédi Bouguila
- Institut Hédi-Raïs d'Ophtalmologie de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Amaria Boumedane
- Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
| | | | | | - Guilherme Castela
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | | | - Violeta S Chernodrinska
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | - Krzysztof Cieslik
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Codruta Comsa
- Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania
| | | | - Monika Csóka
- Semmelweis University Budapest, Budapest, Hungary
| | | | - Alan Davidson
- Red Cross Children's War Memorial Hospital and the University of Cape Town, Cape Town, South Africa
| | | | | | | | | | - Asmaa El Kettani
- Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
| | - Amal M Elbahi
- Tripoli Eye Hospital, Tripoli University, Tripoli, Libya
| | - Dina Elgalaly
- Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | | | - Moawia M Ali Elhassan
- Oncology Department, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
| | - Mahmoud M Elzembely
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Vera A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | - Oluyemi Fasina
- Department of Ophthalmology, University College Hospital/University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Moira Gandiwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Jennifer A Geel
- University of the Witwatersrand, Johannesburg, South Africa.,Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Zelalem Gizachew
- Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia
| | - Pernille A Gregersen
- Department of Clinical Genetics, and Center for Rare Disorders, Aarhus University Hopspital, Aarhus, Denmark
| | - Koffi M Guedenon
- Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | | | - Sadiq Hassan
- Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Department of Rabat - Mohammed V University, Rabat, Morocco
| | - Diriba F Hordofa
- Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Marlies Hummlen
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | | | - Russo Ida
- Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Vesna R Ilic
- Institute for Oncology and Radiology, Belgrade, Serbia
| | - Helen Jenkinson
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Rolande L Kabore
- Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Abubakar Kalinaki
- Makerere University College of Health Sciences, Department of Ophthalmology, Kamplala, Uganda
| | - Noa Kapelushnik
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Tamar Kardava
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Pavlin Kroumov Kemilev
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | - Tomas Kepak
- University Hospital Brno, Masaryk University and ICRC/St. Anna University Hospital, Brno, Czech Republic
| | - Zaza Khotenashvili
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Artur Klett
- East Tallinn Central Hospital, Tallinn, Estonia
| | | | - Dalia Krivaitiene
- Chidren's Ophthalmology Department, Chidren's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Alice Kyara
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | | | - Slobodanka Latinović
- Clinical Center Of Vojvodina - University Eye Clinic, Eye Research Foundation Vidar - Latinović, Novi Sad, Serbia
| | - Karin Lecuona
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Robert M Lukamba
- University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, DRC
| | | | - Lesia Lysytsia
- The Okhmatdyt National Children's Hospital, Kiev, Ukraine
| | - Erika Maka
- Semmelweis University Budapest, Budapest, Hungary
| | - Mayuri Makan
- Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | - Chatonda Manda
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Nieves Martín Begue
- Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - Ismail Mayet
- University of the Witwatersrand, Johannesburg, South Africa
| | - Freddy B Mbumba
- Botswana Government - Scottish Livingstone Hospital, Molepolole, Botswana
| | | | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | - Ahmed A Mohamedani
- Pathology Department, Faculty of Medicine, University of Gezira, Wadi Madani, Sudan
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, Netherlands
| | - Claude Moreira
- Service d'oncologie pédiatrique de l'hôpital Aristide le Dantec, Dakar, Senegal
| | | | - Gerald Msukwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Gabriela Murgoi
- Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania
| | - Kareem O Musa
- Department of Ophthalmology, Lagos University Teaching Hospital/College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Hamzah Mustak
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | | | - Gita Naidu
- University of the Witwatersrand, Johannesburg, South Africa
| | - Larisa Naumenko
- N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus
| | | | - Vladimir Neroev
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | | | - Elizabeth D Nkanga
- Calabar Children's Eye Center, Department of Ophthalmology University of Calabar Teaching Hospital Calabar Cross River State, Nigeria
| | - Henry Nkumbe
- Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
| | | | | | - Ngozi C Oguego
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Andrzej Olechowski
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Alexander Hugo Oscar
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | - Sally L Painter
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Luisa Paiva
- National Ophthalmological Institute of Angola, Luanda, Angola
| | - Ruzanna Papyan
- Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia
| | | | - Manoj Parulekar
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Katarzyna Pawinska-Wasikowska
- Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland
| | - Sanja Perić
- University Hospital Center Zagreb, Zagreb, Croatia
| | - Remezo Philbert
- Center Hospitaliere Universitaire de Kamenge, Bujumbura, Burundi
| | - Pavel Pochop
- Department of Ophthalmology for Children and Adults, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.,Medical Academy of Postgraduate Education, Moscow, Russia
| | - Manca T Pompe
- Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia
| | | | - Léa Raobela
- Center Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Lorna A Renner
- University of Ghana School of Medicine and Dentistry, Korle Bu Teaching Hospital, Accra, Ghana
| | | | | | | | - Petra Ritter-Sovinz
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology/Oncology, Medical University of Graz, Graz, Austria
| | - Svetlana Saakyan
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Azza Ma Said
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | | | | | - Sadik T Sherief
- Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia
| | - Sidi Sidi Cheikh
- Ophthalmology department, Nouakchott Medical University, Nouakchott, Mauritania
| | - Sónia Silva
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | - Grace Ssali
- Mulago National Referral and Teaching Hospital, Kamplala, Uganda
| | - Christina Stathopoulos
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Branka Stirn Kranjc
- Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia
| | - David K Stones
- Department of Paediatrics and Child Health, University of the Free Sate, Bloemfontein, South Africa
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | | | - Gevorg Tamamyan
- Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia
| | - Alketa Tandili
- University Hospital Center 'Mother Theresa', Tirana, Albania
| | | | | | - Fousseyni Traoré
- Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
| | | | - Ali B Umar
- Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Steen F Urbak
- Department of ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Tatiana L Ushakova
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.,Medical Academy of Postgraduate Education, Moscow, Russia
| | | | | | - Nevyana V Veleva-Krasteva
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | | | | | | | | | - Amelia Dc Wime
- National Ophthalmological Institute of Angola, Luanda, Angola
| | | | - Jenny M Yanga
- Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, DRC
| | - Vera A Yarovaya
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Andrey A Yarovoy
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Ekhtelbenina Zein
- Assistante Hospitalo - Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
| | - Shirley Sharabi
- Radiology Department, Sheba Medical Center, Ramat-Gan, Israel
| | | | - Othman Ao Ziko
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Richard Bowman
- Ophthalmology Department, Great Ormond Street Children's Hospital, London, UK
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Adamou Boubacar S, Ademola-Popoola DS, Adio A, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Al Harby L, Al Ani MH, Alakbarova A, Portabella SA, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad C, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amiruddin PO, Antonino R, Astbury NJ, Atalay HT, Atchaneeyasakul LO, Atsiaya R, Attaseth T, Aung TH, Ayala S, Baizakova B, Balaguer J, Balayeva R, Balwierz W, Barranco H, Bascaran C, Beck Popovic M, Benavides R, Benmiloud S, Bennani Guebessi N, Berete RC, Berry JL, Bhaduri A, Bhat S, Biddulph SJ, Biewald EM, Bobrova N, Boehme M, Boldt HC, Bonanomi MTBC, Bornfeld N, Bouda GC, Bouguila H, Boumedane A, Brennan RC, Brichard BG, Buaboonnam J, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Cassoux N, Castela G, Castillo L, Català-Mora J, Chantada GL, Chaudhry S, Chaugule SS, Chauhan A, Chawla B, Chernodrinska VS, Chiwanga FS, Chuluunbat T, Cieslik K, Cockcroft RL, Comsa C, Correa ZM, Correa Llano MG, Corson TW, Cowan-Lyn KE, Csóka M, Cui X, Da Gama IV, Dangboon W, Das A, Das S, Davanzo JM, Davidson A, De Potter P, Delgado KQ, Demirci H, Desjardins L, Diaz Coronado RY, Dimaras H, Dodgshun AJ, Donaldson C, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Edison KS, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elgalaly D, Elhaddad AM, Elhassan MMA, Elzembely MM, Essuman VA, Evina TGA, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Gallie BL, Gandiwa M, Garcia JL, García Aldana D, Gassant PY, Geel JA, Ghassemi F, Girón AV, Gizachew Z, Goenz MA, Gold AS, Goldberg-Lavid M, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Garcia Pacheco HN, Graells J, Green L, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Hassan S, Hassan S, Hederova S, Hernandez J, Hernandez LMC, Hessissen L, Hordofa DF, Huang LC, Hubbard GB, Hummlen M, Husakova K, Hussein Al-Janabi AN, Ida R, Ilic VR, Jairaj V, Jeeva I, Jenkinson H, Ji X, Jo DH, Johnson KP, Johnson WJ, Jones MM, Kabesha TBA, Kabore RL, Kaliki S, Kalinaki A, Kantar M, Kao LY, Kardava T, Kebudi R, Kepak T, Keren-Froim N, Khan ZJ, Khaqan HA, Khauv P, Kheir WJ, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivelä TT, Klett A, Komba Palet JEK, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lachmann ES, Lam CPS, Lam GC, Larson SA, Latinovic S, Laurenti KD, Le BHA, Lecuona K, Leverant AA, Li C, Limbu B, Long QB, López JP, Lukamba RM, Lumbroso L, Luna-Fineman S, Lutfi D, Lysytsia L, Magrath GN, Mahajan A, Majeed AR, Maka E, Makan M, Makimbetov EK, Manda C, Martín Begue N, Mason L, Mason JO, Matende IO, Materin M, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Medina-Sanson A, Mehrvar A, Mengesha AA, Menon V, Mercado GJVD, Mets MB, Midena E, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Morales RA, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KI, Munier FL, Murgoi G, Murray TG, Musa KO, Mushtaq A, Mustak H, Muyen OM, Naidu G, Nair AG, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ngo H, Nieves RM, Nikitovic M, Nkanga ED, Nkumbe H, Nuruddin M, Nyaywa M, Obono-Obiang G, Oguego NC, Olechowski A, Oliver SCN, Osei-Bonsu P, Ossandon D, Paez-Escamilla MA, Pagarra H, Painter SL, Paintsil V, Paiva L, Pal BP, Palanivelu MS, Papyan R, Parrozzani R, Parulekar M, Pascual Morales CR, Paton KE, Pawinska-Wasikowska K, Pe'er J, Peña A, Peric S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov VG, Pompe MT, Pons JJ, Prat D, Prom V, Purwanto I, Qadir AO, Qayyum S, Qian J, 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Global Retinoblastoma Presentation and Analysis by National Income Level. JAMA Oncol 2020; 6:685-695. [PMID: 32105305 PMCID: PMC7047856 DOI: 10.1001/jamaoncol.2019.6716] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.
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Affiliation(s)
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Elhassan Abdallah
- Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco
| | | | | | | | | | - Adedayo Adio
- Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | | | | | - Ada E Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Alia Ahmad
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | | | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Aygun Alakbarova
- Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan
| | | | - Safaa A F Al-Badri
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | | | - Amanda Alejos
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | | | | | | | - Christiane Al-Haddad
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Amany M Ali
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Donjeta B Alia
- University Hospital Center Mother Theresa, Tirana, Albania
| | - Mazin F Al-Jadiry
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | - Hind M Alkatan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hatice T Atalay
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | | | - Rose Atsiaya
- Lighthouse For Christ Eye Centre, Mombasa, Kenya
| | - Taweevat Attaseth
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Than H Aung
- Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar
| | | | - Baglan Baizakova
- Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Honorio Barranco
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maja Beck Popovic
- Pediatric Hematology-Oncology Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Raquel Benavides
- Hospital Nacional de Niños Dr Carlos Sáenz Herrera, San Jose, Costa Rica
| | - Sarra Benmiloud
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | | | - Rokia C Berete
- Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire
| | - Jesse L Berry
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | | | - Sunil Bhat
- Department of Pediatric Hematology and Oncology, Narayana Health City, Bangalore, India
| | | | - Eva M Biewald
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Nadia Bobrova
- The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine
| | - Marianna Boehme
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - H C Boldt
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | | | - Norbert Bornfeld
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Gabrielle C Bouda
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Hédi Bouguila
- Institut Hédi Raïs d'Ophtalmologie, Faculté de Médecine, Université Tunis El Manar, Tunis, Tunisia
| | - Amaria Boumedane
- Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
| | - Rachel C Brennan
- Solid Tumor Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | | | | | | | - Jayne E Camuglia
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Miriam R Cano
- Salud Ocular, Ministerio de Salud Publica, Asuncion, Paraguay
| | | | - Nathalie Cassoux
- Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France
| | - Guilherme Castela
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | | | - Guillermo L Chantada
- Hospital Sant Joan de Déu, Barcelona, Spain
- Hospital Garrahan, Buenos Aires, Argentina
- NationalScientific and Technical Research Council, CONICET, Buenos Aires, Argentina
| | - Shabana Chaudhry
- Paediatric Ophthalmology Department, Mayo Hospital and College of Allied Visual Sciences, King Edward Medical University, Lahore, Pakistan
| | - Sonal S Chaugule
- Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | | | - Bhavna Chawla
- Ocular Oncology Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Violeta S Chernodrinska
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | | | - Krzysztof Cieslik
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | | | - Codruta Comsa
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Zelia M Correa
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | | | | | | | - Xuehao Cui
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Wantanee Dangboon
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Anirban Das
- Department of Pediatric Hematology-Oncology, Tata Medical Center, Kolkata, India
| | - Sima Das
- Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Alan Davidson
- Red Cross War Memorial Children's Hospital and the University of Cape Town, Cape Town, South Africa
| | | | | | - Hakan Demirci
- Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor
| | | | | | - Helen Dimaras
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrew J Dodgshun
- Department of Paediatrics, University of Otago, Christchurch, Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand
| | - Craig Donaldson
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Monica D Dragomir
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Yi Du
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | | | - Kemala S Edison
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | - I Wayan Eka Sutyawan
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | - Asmaa El Kettani
- Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
| | - Amal M Elbahi
- Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya
| | - James E Elder
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Dina Elgalaly
- Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | | | - Moawia M Ali Elhassan
- Department of Oncology, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
| | - Mahmoud M Elzembely
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Vera A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | | | | | - Mohammad Faranoush
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran
| | - Oluyemi Fasina
- Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | | | | | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Shahar Frenkel
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Soad L Fuentes-Alabi
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | | | - Moira Gandiwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | | | - Jennifer A Geel
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Fariba Ghassemi
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ana V Girón
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Zelalem Gizachew
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Marco A Goenz
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | - Aaron S Gold
- Murray Ocular Oncology and Retina, Miami, Florida
| | | | - Glen A Gole
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Nir Gomel
- Department of Ophthalmology, Sourasky Medical Center Tel Aviv, School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efren Gonzalez
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Henry N Garcia Pacheco
- Pediatric Oncology Unit, Instituto Regional de Enfermedades Neoplásicas del Sur, Arequipa, Perú
| | - Jaime Graells
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Liz Green
- IAM NOOR Eye Care Programme, Afghanistan
| | - Pernille A Gregersen
- Department of Clinical Genetics and Center for Rare Disorders, Aarhus University Hospital, Aarhus, Denmark
| | | | - Koffi M Guedenon
- Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | | | - Ahmet K Gündüz
- Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey
| | - Himika Gupta
- Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Sanjiv Gupta
- King George's Medical University, Lucknow, India
| | | | - Patrick Hamel
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | | | | | - Eric D Hansen
- John A. Moran Eye Center, University of Utah, Salt Lake City
| | - J William Harbour
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Murat Hasanreisoglu
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | - Sadiq Hassan
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Shadab Hassan
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Jose Hernandez
- Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Center, Mohammed V University, Rabat, Morocco
| | - Diriba F Hordofa
- Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Laura C Huang
- Byers Eye Institute, Stanford University, Stanford, California
| | | | - Marlies Hummlen
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | | | | | - Russo Ida
- Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Vesna R Ilic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | | | - Helen Jenkinson
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Hyun Jo
- Fight Against Angiogenesis-Related Blindness Laboratory, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - William J Johnson
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Michael M Jones
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Rolande L Kabore
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Swathi Kaliki
- Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | - Abubakar Kalinaki
- Department of Ophthalmology, Makerere University College of Health Sciences Kamplala, Uganda
| | - Mehmet Kantar
- Division of Pediatric Oncology, School of Medicine, Ege University, Izmir, Turkey
| | | | - Tamar Kardava
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine and Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Tomas Kepak
- St. Anne's University Hospital Brno, Masaryk University, and International Clinical Research Center/St Anna University Hospital, Brno, Czech Republic
| | | | | | - Hussain A Khaqan
- Department of Ophthalmology, Postgraduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan
| | - Phara Khauv
- Angkor Hospital for Children, Krong Siem Reap, Cambodia
| | - Wajiha J Kheir
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Alireza Khodabande
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zaza Khotenashvili
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Jonathan W Kim
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Jeong Hun Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hayyam Kiratli
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Artur Klett
- East Tallinn Central Hospital, Tallinn, Estonia
| | | | - Dalia Krivaitiene
- Children's Ophthalmology Department, Children's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Kittisak Kulvichit
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | - Alice Kyara
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Eva S Lachmann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carol P S Lam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Geoffrey C Lam
- Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Scott A Larson
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | - Slobodanka Latinovic
- Clinical Center of Vojvodina, University Eye Clinic, Eye Research Foundation Vidar-Latinović, Novi Sad, Serbia
| | - Kelly D Laurenti
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Bao Han A Le
- John A. Burns School of Medicine, University of Hawaii, Honolulu, and University of Southern California Roski Eye Institute, Los Angeles
| | - Karin Lecuona
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Cairui Li
- Affiliated Hospital of Dali University, Dali City, China
| | - Ben Limbu
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | | | - Juan P López
- Ophthalmology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Robert M Lukamba
- University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, Democratic Rrepublic of Congo
| | | | - Sandra Luna-Fineman
- Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora
| | - Delfitri Lutfi
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - George N Magrath
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Amita Mahajan
- Pediatric Hematology-Oncology Unit, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India
| | | | - Erika Maka
- Semmelweis University, Budapest, Hungary
| | - Mayuri Makan
- Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | | | - Chatonda Manda
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Nieves Martín Begue
- Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Miguel Materin
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Marchelo Matua
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | - Ismail Mayet
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - John D McKenzie
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Ocular Oncology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Aurora Medina-Sanson
- Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | | | | | - Marilyn B Mets
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | | | - Ahmed A Mohamedani
- Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
| | | | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Rosa A Morales
- Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
| | - Claude Moreira
- Service d'Oncologie Pédiatrique de l'Hôpital Aristide le Dantec, Dakar, Senegal
| | | | | | - Gerald Msukwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Gabriela Murgoi
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | | | - Kareem O Musa
- Department of Ophthalmology, Lagos University Teaching Hospital, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Asma Mushtaq
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Hamzah Mustak
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Gita Naidu
- University of the Witwatersrand, Johannesburg, South Africa
| | - Akshay Gopinathan Nair
- Aditya Jyot Eye Hospital, Mumbai, India
- Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India
| | - Larisa Naumenko
- N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus
| | | | - Yetty M Nency
- Child Health Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Vladimir Neroev
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Hang Ngo
- Ho Chi Minh Eye Hospital, Ho Chi Minh, Vietnam
| | - Rosa M Nieves
- Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Marina Nikitovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Elizabeth D Nkanga
- Department of Ophthalmology, Calabar Children's Eye Center, University of Calabar Teaching Hospital, Calabar Nigeria
| | - Henry Nkumbe
- Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
| | - Murtuza Nuruddin
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | | | | | - Ngozi C Oguego
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Andrzej Olechowski
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Scott C N Oliver
- Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora
| | | | - Diego Ossandon
- Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | | | | | - Sally L Painter
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Luisa Paiva
- National Ophthalmological Institute of Angola, Luanda, Angola
| | - Bikramjit P Pal
- H M Diwan Eye Foundation, and Tata Medical Center, Kolkata, India
| | | | - Ruzanna Papyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | | | - Manoj Parulekar
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | | | - Katarzyna Pawinska-Wasikowska
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Jacob Pe'er
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Sanja Peric
- University Hospital Center Zagreb, Zagreb, Croatia
| | - Chau T M Pham
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Remezo Philbert
- Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi
| | | | - Pavel Pochop
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic
| | | | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | - Manca T Pompe
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | | | - Daphna Prat
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | - Ignatius Purwanto
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Seema Qayyum
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Jiang Qian
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Ardizal Rahman
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | | | | | | | | | | | - Marco A Ramirez-Ortiz
- Department of Ophthalmology, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico
| | - Léa Raobela
- Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Riffat Rashid
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Ehud Reich
- Department of Ophthalmology, Davidoff Center for Oncology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel
| | - Lorna A Renner
- School of Medicine and Dentistry, Korle-Bu Teaching Hospital, University of Ghana, Accra, Ghana
| | | | | | | | - Petra Ritter-Sovinz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Livia Romero
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Soma R Roy
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | - Raya H Saab
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Svetlana Saakyan
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Ahmed H Sabhan
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Mandeep S Sagoo
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, United Kingdom
| | - Azza M A Said
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rohit Saiju
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Beatriz Salas
- Hospital Dr Manuel Ascencio Villarroel, Cochabamba, Bolivia
| | | | | | | | | | | | | | - Ahad Sedaghat
- Department of Ophthalmology, Rasool Akram Hospital, Tehran, Iran
| | | | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ankoor S Shah
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Sadik T Sherief
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sorath Noorani Siddiqui
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Sidi Sidi Cheikh
- Ophthalmology Department, Nouakchott Medical University, Nouakchott, Mauritania
| | - Sónia Silva
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | - Arun D Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Usha Singh
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Penny Singha
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Hendrian D Soebagjo
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - Grace Ssali
- Mulago National Referral Hospital, Kampala, Uganda
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle
| | - Sandra E Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Erin D Stahl
- Children's Mercy Hospital, Kansas City, Missouri
| | - Christina Stathopoulos
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Branka Stirn Kranjc
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - David K Stones
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa
| | | | | | - Sadia Sultana
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - Xiantao Sun
- Henan Children's Hospital, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China
| | - Meryl Sundy
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Rosanne Superstein
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | - Eddy Supriyadi
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Shigenobu Suzuki
- Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | | | - Gevorg Tamamyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | - Deborah Tan
- Singapore National Eye Center, Singapore, Singapore
| | - Alketa Tandili
- University Hospital Center Mother Theresa, Tirana, Albania
| | | | - Maryam Tashvighi
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | - Edi S Tehuteru
- National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
| | - Luiz F Teixeira
- Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil
- Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Kok Hoi Teh
- Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Helen Toledano
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doan L Trang
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Fousseyni Traoré
- Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
| | | | - Samuray Tuncer
- Department of Ophthalmology, Faculty of Medicine, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
| | | | - Ali B Umar
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Emel Unal
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | | | - Steen F Urbak
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Tatiana L Ushakova
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | | | | | | | - Adisai Varadisai
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Nevyana V Veleva-Krasteva
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | - Andi A Victor
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | | | - Vicktoria Vishnevskia-Dai
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Keith Waddell
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | | | | | - Yi-Zhuo Wang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Avery Weiss
- Department of Ophthalmology, University of Washington, Seattle
| | - Matthew W Wilson
- Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Amelia D C Wime
- National Ophthalmological Institute of Angola, Luanda, Angola
| | | | | | | | - Phanthipha Wongwai
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Daoman Xiang
- Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | | | - Jason C Yam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huasheng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jenny M Yanga
- Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | - Vera A Yarovaya
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Andrey A Yarovoy
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Huijing Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Putu Yuliawati
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | | | - Ekhtelbenina Zein
- Assistante Hospitalo Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
| | - Chengyue Zhang
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Junyang Zhao
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaoyu Zheng
- Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Nida Zia
- The Indus Hospital, Karachi, Pakistan
| | - Othman A O Ziko
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Ophthalmology Department, Great Ormond Street Hospital, London, United Kingdom
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De Francesco S, Sgheri A, Di Maggio A, Rana F, Anna Maria P, Alessandra R, Hadjistilianou T. Bilateral retinoblastoma and osteogenesis imperfecta, a very rare association: Two cases. Eur J Ophthalmol 2020; 31:NP81-NP84. [PMID: 32314604 DOI: 10.1177/1120672120919344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This case report presents two patients affected by a very rare association of bilateral retinoblastoma and osteogenesis imperfecta. CASE REPORT Two Caucasian males with familial history and clinical signs of osteogenesis imperfecta came to our attention for bilateral leukocoria. The ocular fundus examination revealed bilateral retinoblastoma. Proper therapies were dispensed in order to achieve full regression. Genetic counseling was performed. DISCUSSION The primary role of genetics in retinoblastoma pathogenesis in widely known, and different genes have been identified. Osteogenesis imperfecta is a rare connective tissue disorders, caused by mutated genes encoding for collagen. The single gene defect in osteogenesis imperfecta type VI is Serpin Family F Member 1 (SERPINF1), a neurotrophic factor for the neuronal differentiation in retinoblastoma cells. The association of bilateral retinoblastoma and osteogenesis imperfecta could be the result of the mutation of a single gene playing a role in a hypothetical common pathway.
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Affiliation(s)
| | - Arianna Sgheri
- Department of Ophthalmology, University of Siena, Siena, Italy
| | | | - Francesco Rana
- Department of Ophthalmology, University of Siena, Siena, Italy
| | - Pinto Anna Maria
- Department of Medical Biotechnologies and Genetics, University of Siena, Siena, Italy
| | - Renieri Alessandra
- Department of Medical Biotechnologies and Genetics, University of Siena, Siena, Italy
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Gelli E, Pinto AM, Somma S, Imperatore V, Cannone MG, Hadjistilianou T, De Francesco S, Galimberti D, Currò A, Bruttini M, Mari F, Renieri A, Ariani F. Evidence of predisposing epimutation in retinoblastoma. Hum Mutat 2018; 40:201-206. [PMID: 30427563 DOI: 10.1002/humu.23684] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/04/2018] [Accepted: 11/12/2018] [Indexed: 01/17/2023]
Abstract
Retinoblastoma (RB), which represents the most common childhood eye cancer, is caused by biallelic inactivation of RB1 gene. Promoter hypermethylation is quite frequent in RB tissues but conclusive evidence of soma-wide predisposing epimutations is currently scant. Here, 50 patients who tested negative for RB1 germline sequence alterations were screened for aberrant promoter methylation using methylation-specific MLPA. The assay, performed on blood, identified a sporadic patient with methylation of CpG106, absent in parents' DNA. Bisulfite pyrosequencing accurately quantified CpG methylation in blood DNA (mean ∼49%) and also confirmed the aberration in DNA isolated from oral mucosa although at lower levels (mean ∼34%). Using a tag-SNP, methylation was demonstrated to affect the maternal allele. Real-time qPCR demonstrated RB1 transcriptional silencing. In conclusion, we documented that promoter methylation can act as the first "hit" in Knudson's model. This mosaic epimutation mimics the effect of an inactivating mutation and phenocopies RB onset.
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Affiliation(s)
- Elisa Gelli
- Medical Genetics, University of Siena, Siena, Italy
| | - Anna Maria Pinto
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Serena Somma
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Marta G Cannone
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Theodora Hadjistilianou
- Unit of Ophthalmology and Retinoblastoma Referral Center, Department of Surgery, University of Siena, Policlinico 'Santa Maria alle Scotte', Siena, Italy
| | - Sonia De Francesco
- Unit of Ophthalmology and Retinoblastoma Referral Center, Department of Surgery, University of Siena, Policlinico 'Santa Maria alle Scotte', Siena, Italy
| | - Daniela Galimberti
- Unit of Pediatrics, Department of Maternal, Newborn and Child Health, Azienda Ospedaliera Universitaria Senese, Policlinico 'Santa Maria alle Scotte', Siena, Italy
| | - Aurora Currò
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Mirella Bruttini
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Francesca Mari
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Alessandra Renieri
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Francesca Ariani
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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16
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Imperatore V, Pinto AM, Gelli E, Trevisson E, Morbidoni V, Frullanti E, Hadjistilianou T, De Francesco S, Toti P, Gusson E, Roversi G, Accogli A, Capra V, Mencarelli MA, Renieri A, Ariani F. Parent-of-origin effect of hypomorphic pathogenic variants and somatic mosaicism impact on phenotypic expression of retinoblastoma. Eur J Hum Genet 2018; 26:1026-1037. [PMID: 29662154 DOI: 10.1038/s41431-017-0054-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 11/09/2022] Open
Abstract
Retinoblastoma is the most common eye cancer in children. Numerous families have been described displaying reduced penetrance and expressivity. An extensive molecular characterization of seven families led us to characterize the two main mechanisms impacting on phenotypic expression, as follows: (i) mosaicism of amorphic pathogenic variants; and (ii) parent-of-origin-effect of hypomorphic pathogenic variants. Somatic mosaicism for RB1 splicing variants (c.1960+5G>C and c.2106+2T>C), leading to a complete loss of function was demonstrated by high-depth NGS in two families. In both cases, the healthy carrier parent (one with retinoma) showed a variant frequency lower than that expected for a heterozygous individual, indicating a 56-60% mosaicism level. Previous evidences of a ~3-fold excess of RB1 maternal canonical transcript led us to hypothesize that this differential allelic expression could influence phenotypic outcome in families at risk for RB onset. Accordingly, in five families, we identified a higher tumor risk associated with paternally inherited hypomorphic pathogenic variants, namely a deletion resulting in the loss of 37 amino acids at the N-terminus (c.608-16_608del), an exonic substitution with a "leaky" splicing effect (c.1331A>G), a partially deleterious substitution (c.1981C>T) and a truncating C-terminal variant (c.2663+2T>C). The identification of these mechanisms changes the genetic/prenatal counseling and the clinical management of families, indicating a higher recurrence risk when the hypomorphic pathogenic variant is inherited from the father, and suggesting the need for second tumor surveillance in unaffected carriers at risk of developing adult-onset cancer such as osteosarcoma or leiomyosarcoma.
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Affiliation(s)
| | - Anna Maria Pinto
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Elisa Gelli
- Medical Genetics, University of Siena, Siena, Italy
| | - Eva Trevisson
- Department of Woman and Child Health, University of Padova Istituto di Ricerca Pediatrica, IRP, Città della Speranza, Padova, Italy.,Istituto di Ricerca Pediatrica, IRP, Città della Speranza, Padova, Italy
| | - Valeria Morbidoni
- Department of Woman and Child Health, University of Padova Istituto di Ricerca Pediatrica, IRP, Città della Speranza, Padova, Italy.,Istituto di Ricerca Pediatrica, IRP, Città della Speranza, Padova, Italy
| | | | - Theodora Hadjistilianou
- Unit of Ophthalmology and Retinoblastoma Referral Center, Department of Surgery, University of Siena, Policlinico 'Santa Maria alle Scotte', Siena, Italy
| | - Sonia De Francesco
- Unit of Ophthalmology and Retinoblastoma Referral Center, Department of Surgery, University of Siena, Policlinico 'Santa Maria alle Scotte', Siena, Italy
| | - Paolo Toti
- Department of Medical Biotechnology, Section of Pathology, University of Siena, Policlinico 'Santa Maria alle Scotte', Siena, Italy
| | - Elena Gusson
- Unit of Ophthalmology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Gaia Roversi
- Department of Medicine and Surgery, University Milan-Bicocca; Ospedale San Gerardo, ASST Monza, Monza, Italy
| | | | | | - Maria Antonietta Mencarelli
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Alessandra Renieri
- Medical Genetics, University of Siena, Siena, Italy. .,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
| | - Francesca Ariani
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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17
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Hadjistilianou T, De Francesco S, Marconcini S, Mastrangelo D, Galluzzi P, Toti P. Phthisis Bulbi and Buphthalmos as Presenting Signs of Retinoblastoma: A Report of Two Cases and Literature Review. Eur J Ophthalmol 2018; 16:465-9. [PMID: 16761252 DOI: 10.1177/112067210601600318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report two cases of bilateral retinoblastoma (RB) with unusual presentations. METHODS The medical records of 321 patients from the Retinoblastoma Referral Center in Siena were reviewed. A total of 111 patients had bilateral RB, 2 of them presenting with phthisis bulbi and buphthalmos. Both patients underwent bilateral enucleation. Clinical features, imaging studies, and histopathology were reviewed. RESULTS These 2 cases represent 0.62% (2/321) in our series. Histopathology did not reveal viable tumor cells in the phthisical eyes; in both buphthalmic eyes the tumor was active, infiltrating the choroid and optic nerve. CONCLUSIONS Phthisis bulbi and buphthalmos are unusual presenting signs of RB. This very rare combination of these two signs in different eyes of the same patient is probably due to a delay in diagnosis.
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Affiliation(s)
- T Hadjistilianou
- Retinoblastoma Referral Center, Department of Ophthalmologycal Sciences, Azienda Ospedaliera e Universitaria Senese, University of Siena, Siena, Italy.
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18
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Abstract
PURPOSE To report a case of bilateral retinocytoma associated with calcified vitreous deposits. METHODS Case report. RESULTS On routine examination, a 35-year-old asymptomatic father of a child with bilateral retinoblastoma presented bilateral retinocytoma associated with vitreous calcifications, in the vicinity of the retinocytoma in his left eye. Fundus photographic documentation and fluorescein angiography were performed. The patient has been followed up for 10 years. CONCLUSIONS The lesions in both eyes have remained stable without signs of growth or malignant transformation. Calcified vitreous deposits are a recently described feature of retinocytoma in addition to the three classic features: translucent retinal mass, retinal pigment epithelial alteration, and calcification.
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Affiliation(s)
- T Hadjistilianou
- Department of Ophthalmological and Neurosurgical Sciences, University of Siena, Siena, Italy.
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Abramson DH, Shields CL, Jabbour P, Teixeira LF, Fonseca JRF, Marques MCP, Munier FL, Puccinelli F, Hadjistilianou T, Bracco S, Chantada G, Ceciliano A, Gobin YP. Metastatic deaths in retinoblastoma patients treated with intraarterial chemotherapy (ophthalmic artery chemosurgery) worldwide. Int J Retina Vitreous 2017; 3:40. [PMID: 29085670 PMCID: PMC5651563 DOI: 10.1186/s40942-017-0093-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/07/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Ophthalmic artery chemosurgery [OAC, intra-arterial chemotherapy (IAC)] was introduced in 2006 as treatment modality for intraocular retinoblastoma. The purpose of this commentary is to retrospectively review the incidence of metastatic deaths in retinoblastoma patients treated with OAC worldwide over a 10 year period. Retrospective data regarding metastatic deaths was collected from six international retinoblastoma centers (New York City USA, Philadelphia USA, Sao Paulo Brazil, Siena Italy, Lausanne Switzerland and Buenos Aires Argentina). All retinoblastoma patients from these centers (naive and recurrent, unilateral and bilateral) treated with OAC/IAC since 2006 have been included in this study. Data regarding number of patients, number of OAC/IAC infusions, number unilateral and bilateral, number treated for naive disease or salvage and number of metastatic deaths have been assessed. Over a 10-year period of time 1139 patients received OAC/IAC for 4396 infusions. At last follow-up there were only three metastatic deaths (all treated in Buenos Aires). CONCLUSION The current survey assessed the recorded risk of metastatic deaths in six retinoblastoma centers worldwide in children with retinoblastoma (unilateral or bilateral) treated with OAC/IAC as primary or secondary therapy. Overall, the observed risk for metastatic deaths from retinoblastoma was <1% in OAC/IAC treated children.
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Affiliation(s)
- David H Abramson
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065 USA.,Department of Ophthalmology, Weill-Cornell Medical School New York, New York, NY 10065 USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107 USA
| | - Pascal Jabbour
- Department of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107 USA
| | - Luiz Fernando Teixeira
- Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo, 04021-001 Brazil
| | - José Roberto Falco Fonseca
- Diagnostic Imaging Department, Pediatric Oncology Institute, Federal University of São Paulo (UNIFESP), São Paulo, 04021-001 Brazil
| | | | - Francis L Munier
- Unit of Pediatric Ocular Oncology, Jules-Gonin Eye Hospital, University of Lausanne, 1015 Lausanne, Switzerland
| | - Francesco Puccinelli
- Interventional Neuroradiology Unit, Department of Radiology, Centre Hospitalier Iniversitaire Vaudois, 1011 Lausanne, Switzerland
| | | | - Sandra Bracco
- Neurological and Sensorineural Department, Azienda Universitaria Ospedaliera Sense, 53100 Siena, Italy
| | - Guillermo Chantada
- Hematology Oncology Service, Hospital JP Garrahan, 1800 Buenos Aires, Argentina
| | - Alejandro Ceciliano
- Interventional Radiology, Hospital Universitario Austral, 1500 Buenos Aires, Argentina
| | - Y Pierre Gobin
- Department of Radiology and Neurosurgery, New York Presbyterian Hospital, New York, NY 10065 USA
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Esposti G, Borri M, De Francesco S, Coriolani G, Hadjistilianou T. A case of misdiagnosed diffuse infiltrating retinoblastoma. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.04143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G. Esposti
- Ophthalmology; University of Siena; Siena Italy
| | - M. Borri
- Ophthalmology; University of Siena; Siena Italy
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Hadjistilianou T. Pediatric tumors of the iris. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T. Hadjistilianou
- Dipartimento di Scienze Oftalmolgiche; Centro Regionale di Riferimento per il Retinoblastoma; Sienna Italy
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22
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Esposti G, Esposti P, Fruschelli M, Hadjistilianou T. Photostimulation with subthreshold yellow micropulsed laser for chronic residual subfoveal rhegmatogenous retinal detachment after surgery. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- G. Esposti
- Ophthalmology; University of Siena; Siena Italy
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23
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Coriolani G, Galimberti D, Guglielmucci D, Caini M, De Francesco S, Esposti G, Bracco S, Galluzzi P, Toti P, Pinto A, Favre C, Grosso S, Hadjistilianou T. Outcome of retinoblastoma patients treated according to the University Hospital of Siena guidelines. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.04142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. Coriolani
- School of Pediatrics- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - D. Galimberti
- Unit of Pediatrics- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - D.F. Guglielmucci
- Unit of Pediatrics- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - M. Caini
- Unit of Pediatrics- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - S. De Francesco
- Unit of Ophthalmology-Retinoblastoma Referral Center- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - G. Esposti
- School of Ophthalmology- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - S. Bracco
- Unit of Neuroimaging and Neurointervention, NINT- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - P. Galluzzi
- Unit of Neuroimaging and Neurointervention, NINT- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - P. Toti
- Unit of Pathology- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - A.M. Pinto
- Unit of Genetics- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - C. Favre
- Head of the Unit of Pediatric Onco-hematology- Head of the Regional Center of Pediatric Onco-hematology CROP; Azienda Ospedaliero Universitaria Meyer; Florence Italy
| | - S. Grosso
- Head of the Unit of Pediatrics- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
| | - T. Hadjistilianou
- Unit of Ophthalmology- Head of the Retinoblastoma Referral Center- Policlinico “Le Scotte”; Azienda Ospedaliero Universitaria Senese; Siena Italy
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24
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Hadjistilianou T, Galluzzi P, Toti P, Menicacci F, Menicacci C, Daini R, Pica A, Zografos L. Orbital recurrence of uveal melanoma after 45 years from enucleation. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.04144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- T. Hadjistilianou
- Dipartimento di Scienze Oftalmolgiche; Centro di Riferimento per il Retinoblastoma; Siena Italy
| | | | - P. Toti
- Pathology; Anatomy and Pathology; Siena Italy
| | - F. Menicacci
- Dipartimento di Scienze Oftalmolgiche; Medicine and Surgery; Siena Italy
| | - C. Menicacci
- Dipartimento di Scienze Oftalmolgiche; Medicine and Surgery; Siena Italy
| | - R. Daini
- Ophthalmic Echography; Bologna Italy
| | - A. Pica
- Radiotherapy; Jules Gonin; Lausanne Switzerland
| | - L. Zografos
- Ophthalmic Oncology; Jules Gonin; Lausanne Switzerland
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De Francesco S, Hadjistilianou T, Borri M. Alternated intra-arterial and intravitreal chemotherapy: successes and failures of advanced intraocular retinoblastoma treated without systemic chemotherapy. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - M. Borri
- Ophthalmology; University of Siena; Siena Italy
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Abstract
From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree) Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support for parents when neonatal retinoblastoma has been diagnosed.
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Affiliation(s)
- Tero T Kivelä
- Department of Ophthalmology, Ocular Oncology and Pediatric Ophthalmology Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Theodora Hadjistilianou
- Unit of Ophthalmology and Referral Center for Retinoblastoma, Department of Surgery, Policlinico "Santa Maria alle Scotte", Siena, Italy
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Hadjistilianou T, Mittica P, Bagaglia S, Fruschelli M, Menicacci C, Fusco F, Defrancesco S, Borri M, Galluzzi P. Congenital malignant ciliary body medullepithelioma in two newborns. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fruschelli M, Fazio S, Capozzoli M, Chimenti G, Hadjistilianou T, Sicuranza A, Aprile L, Puccetti L. Incidence of retinal vein occlusions (RVO) in patients treated with oral anticoagulants or antiplatelet drugs for cardioembolic or atherothrombotic prevention. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stacey AW, Borri M, Francesco SD, Antenore AS, Menicacci F, Hadjistilianou T. A Case of Anterior Chamber Cholesterolosis Due to Coats' Disease and a Review of Reported Cases. Open Ophthalmol J 2016; 10:27-32. [PMID: 27014384 PMCID: PMC4780468 DOI: 10.2174/1874364101610010027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/12/2015] [Accepted: 11/15/2015] [Indexed: 11/22/2022] Open
Abstract
Purpose: To present the case of an 18 month old boy with Coats' disease who was found to have anterior chamber cholesterolosis. Methods: Case presentation and review of reported cases. Results: An 18 month old boy presented with unilateral stage 3B Coats' disease without other clinical findings. Two weeks after presentation he returned with xanthocoria due to anterior chamber cholesterolosis. He subsequently developed hyphema, neovascular glaucoma, and was enucleated. His case is compared to all previously reported cases of Coats' disease leading to anterior chamber cholesterolosis. Conclusion: The presentation of anterior chamber cholesterolosis in Coats' disease can range from the incidental finding in an asymptomatic patient to acute angle closure glaucoma with pain and acutely decreased vision. Clinicians should be aware of this potential complication of Coats' disease as it denotes a poor visual prognosis.
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Affiliation(s)
- Andrew W Stacey
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Melissa Borri
- Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte" Siena, Italy
| | - Sonia De Francesco
- Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte" Siena, Italy
| | - Angela S Antenore
- Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte" Siena, Italy
| | - Felice Menicacci
- Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte" Siena, Italy
| | - Theodora Hadjistilianou
- Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte" Siena, Italy
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30
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Bertelli E, Leonini S, Galimberti D, Moretti S, Tinturini R, Hadjistilianou T, De Francesco S, Romano DG, Vallone IM, Cioni S, Gennari P, Galluzzi P, Grazzini I, Rossi S, Bracco S. Hemodynamic and Anatomic Variations Require an Adaptable Approach during Intra-Arterial Chemotherapy for Intraocular Retinoblastoma: Alternative Routes, Strategies, and Follow-Up. AJNR Am J Neuroradiol 2016; 37:1289-95. [PMID: 26915566 DOI: 10.3174/ajnr.a4741] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/09/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Intra-arterial chemotherapy for retinoblastoma is not always a straightforward procedure, and it may require an adaptable approach. This study illustrates strategies used when the ophthalmic artery is difficult to catheterize or not visible, and it ascertains the effectiveness and safety of these strategies. MATERIALS AND METHODS A retrospective study was performed on a series of 108 eyes affected by intraocular retinoblastoma and selected for intra-arterial chemotherapy (follow-up range, 6-82 months). We recognized 3 different patterns of drug delivery: a fixed pattern through the ophthalmic artery, a fixed pattern through branches of the external carotid artery, and a variable pattern through either the ophthalmic or the external carotid artery. RESULTS We performed 448 sessions of intra-arterial chemotherapy, 83.70% of them through the ophthalmic artery and 16.29% via the external carotid artery. In 24.52% of eyes, the procedure was performed at least once through branches of the external carotid artery. In 73 eyes, the pattern of drug delivery was fixed through the ophthalmic artery; for 9 eyes, it was fixed through branches of the external carotid artery; and for 17 eyes, the pattern was variable. Statistical analysis did not show any significant difference in the clinical outcome of the eyes (remission versus enucleation) treated with different patterns of drug delivery. Adverse events could not be correlated with any particular pattern. CONCLUSIONS Alternative routes of intra-arterial chemotherapy for intraocular retinoblastoma appear in the short term as effective and safe as the traditional drug infusion through the ophthalmic artery.
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Affiliation(s)
- E Bertelli
- From the Department of Molecular and Developmental Medicine (E.B., S.R.), University of Siena, Siena, Italy
| | - S Leonini
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | | | | | - R Tinturini
- Neurosurgical Intensive Care (R.T.), Azienda Ospedaliera Universitaria Senese, University of Siena, Policlinico "Santa Maria alle Scotte," Siena, Italy
| | - T Hadjistilianou
- Department of Medicine, Surgery and Neuroscience (T.H., S.D.F.), Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte," Siena, Italy
| | - S De Francesco
- Department of Medicine, Surgery and Neuroscience (T.H., S.D.F.), Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte," Siena, Italy
| | - D G Romano
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - I M Vallone
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - S Cioni
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - P Gennari
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - P Galluzzi
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - I Grazzini
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - S Rossi
- From the Department of Molecular and Developmental Medicine (E.B., S.R.), University of Siena, Siena, Italy
| | - S Bracco
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
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Galluzzi P, Hadjistilianou T, Cerase A, Toti P, Leonini S, Bracco S, de Francesco S, Galimberti D, Balducci D, Piu P, Monti L, Bellini M, Caini M, Rossi A. MRI helps depict clinically undetectable risk factors in advanced stage retinoblastomas. Neuroradiol J 2015; 28:53-61. [PMID: 25924174 DOI: 10.15274/nrj-2014-10103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study compared high-resolution MRI with histology in advanced stage retinoblastomas in which ophthalmoscopy and ultrasonography did not give an exhaustive depiction of the tumour and/or its extension. MRI of orbits and head in 28 retinoblastoma patients (28 eyes) treated with primary enucleation were evaluated. Iris neoangiogenesis, infiltrations of optic nerve, choroid, anterior segment and sclera suspected at MR and histology were compared. Abnormal anterior segment enhancement (AASE) was also correlated with histologically proven infiltrations. Brain images were also evaluated. Significant values were obtained for: prelaminar optic nerve (ON) sensitivity (0.88), positive predictive value (PPV) (0.75) and negative predictive value (NPV) (0.71); post-laminar ON sensitivity (0.50), specificity (0.83), PPV (0.50) and NPV (0.83); overall choroid sensitivity (0.82), and massive choroid NPV (0.69); scleral specificity (1), and NPV (1). AASE correlated with iris neoangiogenesis in 14 out of 19 eyes, and showed significant values for: overall ON PPV (0.65), prelaminar ON sensitivity (0.65), and PPV (0.61), post-laminar ON NPV (0.64); overall choroid sensitivity (0.77), PPV (0.59) and NPV (0.73); scleral NPV (0.83); anterior segment sensitivity (1), and NPV (1). Odds ratios (OR) and accuracy were significant in scleral and prelaminar optic nerve infiltration. Brain examination was unremarkable in all cases. High-resolution MRI may add important findings to clinical evaluation of advanced stage retinoblastomas.
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Affiliation(s)
| | | | | | - Paolo Toti
- Section of Pathology, Department of Medical Biotechnologies
| | - Sara Leonini
- Neuroimaging and Neurointerventional (NINT) Unit
| | | | - Sonia de Francesco
- Unit of Ophthalmology and Retinoblastoma Referral Centre, Department of Surgery
| | - Daniela Galimberti
- Unit of Paediatrics, Department of Maternal, Newborn and Child Health, University of Siena, "Santa Maria alle Scotte" Hospital; Siena, Italy
| | | | - Pietro Piu
- Department of Medicine, Surgery and Neuroscience, University of Siena; Siena, Italy
| | - Lucia Monti
- Neuroimaging and Neurointerventional (NINT) Unit
| | | | - Mauro Caini
- Unit of Paediatrics, Department of Maternal, Newborn and Child Health, University of Siena, "Santa Maria alle Scotte" Hospital; Siena, Italy
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Lembo A, Pichi F, Santangelo E, Carrai P, Hadjistilianou T, Serafino M, Nucci P. Two masquerade presentations of retinoblastoma. Int Ophthalmol 2015; 36:275-9. [PMID: 26449229 DOI: 10.1007/s10792-015-0134-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 10/04/2015] [Indexed: 11/30/2022]
Abstract
Masquerade syndromes are disorders occurring with intraocular inflammation misdiagnosed as uveitis. The underlying causes may be benign or malignant conditions, and one of the most important diagnoses to take into consideration in children is retinoblastoma. We present two cases with uncertain early misdiagnosis whose definite diagnosis eventually was retinoblastoma.
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Affiliation(s)
- Andrea Lembo
- San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, 20123, Milan, Italy.
| | - Francesco Pichi
- San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, 20123, Milan, Italy
| | - Elisabetta Santangelo
- San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, 20123, Milan, Italy
| | - Paola Carrai
- San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, 20123, Milan, Italy
| | - Theodora Hadjistilianou
- Department of Ophthalmology, Azienda Ospedaliera e Universitaria Santa Maria alle Scotte, Siena, Italy
| | - Massimiliano Serafino
- San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, 20123, Milan, Italy
| | - Paolo Nucci
- San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, 20123, Milan, Italy
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Stacey AW, Sparagna C, Borri M, Rizzo S, Hadjistilianou T. A 6-year-old boy with Cornelia de Lange syndrome and Coats disease: case report and review of the literature. J AAPOS 2015; 19:474-8. [PMID: 26486036 DOI: 10.1016/j.jaapos.2015.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 03/27/2015] [Accepted: 03/30/2015] [Indexed: 11/18/2022]
Abstract
Cornelia de Lange syndrome (CdLS) can result in multiple congenital abnormalities and numerous ocular findings. We report the case of a 6-year-old boy with history of CdLS who presented with Coats disease. The findings in this case are compared to those found in the two previously reported cases of concomitant CdLS and Coats disease. The low incidence of these two disorders makes it highly unlikely that the connection is random in these 3 cases. The number of patients with both Cornelia de Lange syndrome and Coats disease is likely underestimated due to the difficulty in examining the peripheral retina in this patient population.
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Affiliation(s)
- Andrew W Stacey
- Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan.
| | - Cristina Sparagna
- Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Melissa Borri
- Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy
| | | | - Theodora Hadjistilianou
- Unit of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy
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Hadjistilianou T, Borri M, De Francesco S, Sparagna C. Intravitreal chemotherapy in advanced retinoblastoma: results and complications. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T. Hadjistilianou
- Dipartimento di scienze oftalmolgiche; Centro Regionale di Riferimento per il Retinoblastoma; Sienna Italy
| | - M. Borri
- Dipartimento di scienze oftalmolgiche; Centro Regionale di Riferimento per il Retinoblastoma; Sienna Italy
| | - S. De Francesco
- Dipartimento di scienze oftalmolgiche; Centro Regionale di Riferimento per il Retinoblastoma; Sienna Italy
| | - C. Sparagna
- Dipartimento di scienze oftalmolgiche; Centro Regionale di Riferimento per il Retinoblastoma; Sienna Italy
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Galluzzi P, Occhini R, Toti P, Hadjistilianou T, Venturi C, Francesco S, Cerase A. Pediatric focally pigmented choroidal melanoma: Imaging with pathological correlation. J Pediatr Neuroradiol 2015. [DOI: 10.3233/pnr-13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Paolo Galluzzi
- Unit of Neuroimaging and Neurointervention (NINT), Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Rossella Occhini
- Section of Pathology, Department of Human Pathology and Oncology, University of Siena, Siena, Italy
| | - Paolo Toti
- Section of Pathology, Department of Human Pathology and Oncology, University of Siena, Siena, Italy
| | - Theodora Hadjistilianou
- Unit of Ophthalmology, and Retinoblastoma Referral Center, Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Carlo Venturi
- Unit of Neuroimaging and Neurointervention (NINT), Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Sonia Francesco
- Unit of Ophthalmology, and Retinoblastoma Referral Center, Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Alfonso Cerase
- Unit of Neuroimaging and Neurointervention (NINT), Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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Bracco S, Venturi C, Leonini S, Romano DG, Cioni S, Vallone IM, Gennari P, Hadjistilianou T, De Francesco S, Bertelli E. Transorbital anastomotic pathways between the external and internal carotid systems in children affected by intraocular retinoblastoma. Surg Radiol Anat 2015. [PMID: 26198114 DOI: 10.1007/s00276-015-1519-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE It is well known that many anastomoses can join the external carotid system and the ophthalmic artery. However, their frequency has never been reported. Since they can be relevant for interventional radiologists operating in the orbit, we decided to illustrate and determine the frequency of the anastomoses that can be found in children. METHODS A retrospective study of 443 angiographic procedures (via ophthalmic artery and/or external carotid artery) carried out on 97 children affected by intraocular retinoblastoma was made to investigate the arterial anatomy of 106 orbits. RESULTS Anastomoses were observed in 44.33 % of orbits. However, their true frequency is likely much higher as the rate of visualization increased up to 91.11 % of orbits when the angiographic study was extended to the external carotid artery. In order of frequency we detected the following anastomoses: lacrimal artery-middle meningeal artery, lacrimal artery-anterior deep temporal artery, ophthalmic artery-middle meningeal artery, ophthalmic artery-facial artery, supraorbital artery-superficial temporal artery, supratrochlear artery-superficial temporal artery, supraorbital artery-middle meningeal artery, dorsal nasal artery-infraorbital artery, supraorbital artery-zygomaticoorbital artery, lacrimal artery-zygomaticoorbital artery. CONCLUSION When properly searched, anastomoses between the ophthalmic artery and the external carotid artery are almost constant in children. Depending on the clinical scenario, they can represent dangers or valuable alternative routes for collateral circulations and intraarterial chemotherapy.
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Affiliation(s)
- Sandra Bracco
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Carlo Venturi
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Sara Leonini
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Daniele G Romano
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Samuele Cioni
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Ignazio M Vallone
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Paola Gennari
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Theodora Hadjistilianou
- Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
- Referral Center for Retinoblastoma, University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Sonia De Francesco
- Referral Center for Retinoblastoma, University of Siena, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Eugenio Bertelli
- Department of Life Sciences, University of Siena, Via Aldo Moro 2, 53100, Siena, Italy.
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Bracco S, Venturi C, Leonini S, Romano DG, Cioni S, Vallone IM, Gennari P, Galluzzi P, Hadjistilianou T, De Francesco S, Guglielmucci D, Tarantino F, Bertelli E. Identification of Intraorbital Arteries in Pediatric Age by High Resolution Superselective Angiography. Orbit 2015; 34:237-47. [PMID: 26154349 DOI: 10.3109/01676830.2015.1049368] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Angiography is a powerful tool to identify intraorbital arteries. However, the incidence by which these vessels can be identified is unknown. Our purpose was to determine such incidence and which angiographic approach is best for the identification of each artery. METHODS A retrospective study of 353 angiographic procedures (via ophthalmic artery and/or external carotid artery) carried out on 79 children affected by intraocular retinoblastoma was made to investigate the arterial anatomy in 87 orbits. For each intraorbital artery two parameters were calculated: the angiographic incidence, as the percentage of times a given artery was identified, and the visibility index, as the ratio between the angiographic incidence and the true anatomic incidence. RESULTS All collaterals of the ophthalmic artery could be spotted. Most of them were identified with a high angiographic incidence; some of them were less easily identified because too thin or because frequently shielded. The visibility index paralleled the angiographic incidence of most arteries. However, the lacrimal and meningolacrimal arteries had a higher visibility index suggesting that their identification was more frequent than the angiographic incidence alone could suggest. Statistical analysis demonstrated that the lacrimal artery and some muscular branches had higher chances to be identified if the angiography of the ophthalmic artery was accompanied by the study of the external carotid system. CONCLUSION This work provides an objective measure of how powerful angiography is to identify intraorbital arteries as well as useful references for professionals who need to operate in the orbit.
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Affiliation(s)
- Sandra Bracco
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Carlo Venturi
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Sara Leonini
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Daniele G Romano
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Samuele Cioni
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Ignazio M Vallone
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Paola Gennari
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Paolo Galluzzi
- a Unit of Neuroimaging and Neurointervention (NINT) , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Theodora Hadjistilianou
- b Department of Medicine , Surgery and Neuroscience, Unit of Ophthalmology, University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy .,c Referral Center for Retinoblastoma, University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Sonia De Francesco
- c Referral Center for Retinoblastoma, University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Daria Guglielmucci
- d Unit of Pediatrics , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy
| | - Francesca Tarantino
- e Unit of Neurosurgical Intensive Care , Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena , Policlinico "Santa Maria alle Scotte," Siena , Italy , and
| | - Eugenio Bertelli
- f Department of Life Sciences , University of Siena , Siena , Italy
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Rodjan F, de Graaf P, van der Valk P, Hadjistilianou T, Cerase A, Toti P, de Jong MC, Moll AC, Castelijns JA, Galluzzi P. Detection of calcifications in retinoblastoma using gradient-echo MR imaging sequences: comparative study between in vivo MR imaging and ex vivo high-resolution CT. AJNR Am J Neuroradiol 2015; 36:355-60. [PMID: 25523593 DOI: 10.3174/ajnr.a4163] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intratumoral calcifications are very important in the diagnosis of retinoblastoma. Although CT is considered superior in detecting calcification, its ionizing radiation, especially in patients with hereditary retinoblastoma, should be avoided. The purpose of our study was to validate T2*WI for the detection of calcification in retinoblastoma with ex vivo CT as the criterion standard. MATERIALS AND METHODS Twenty-two consecutive patients with retinoblastoma (mean age, 21 months; range, 1-71 months) with enucleation as primary treatment were imaged at 1.5T by using a dedicated surface coil. Signal-intensity voids indicating calcification on T2*WI were compared with ex vivo high-resolution CT, and correlation was scored by 2 independent observers as poor, good, or excellent. Other parameters included the shape and location of the signal-intensity voids. In 5 tumors, susceptibility-weighted images were evaluated. RESULTS All calcifications visible on high-resolution CT could be matched with signal-intensity voids on T2*WI, and correlation was scored as excellent in 17 (77%) and good in 5 (23%) eyes. In total, 93% (25/27) of the signal-intensity voids inside the tumor correlated with calcifications compared with none (0/8) of the signal-intensity voids outside the tumor. Areas of nodular signal-intensity voids correlated with calcifications in 92% (24/26), and linear signal-intensity voids correlated with hemorrhage in 67% (6/9) of cases. The correlation of signal-intensity voids on SWI was better in 4 of 5 tumors compared with T2*WI. CONCLUSIONS Signal-intensity voids on in vivo T2*WI correlate well with calcifications on ex vivo high-resolution CT in retinoblastoma. Gradient-echo sequences may be helpful in the differential diagnosis of retinoblastoma. The combination of funduscopy, sonography, and high-resolution MR imaging with gradient-echo sequences should become the standard diagnostic approach for retinoblastoma.
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Affiliation(s)
- F Rodjan
- From the Departments of Radiology (F.R., P.d.G., M.C.d.J., J.A.C.)
| | - P de Graaf
- From the Departments of Radiology (F.R., P.d.G., M.C.d.J., J.A.C.)
| | | | | | - A Cerase
- Neuroimaging and Neurointerventional Unit (A.C., P.G.)
| | - P Toti
- Pathology (P.T.), Azienda Ospedaliera e Universitaria, Santa Maria alle Scotte, Siena, Italy
| | - M C de Jong
- From the Departments of Radiology (F.R., P.d.G., M.C.d.J., J.A.C.)
| | - A C Moll
- Ophthalmology (A.C.M.), VU University Medical Center, Amsterdam, the Netherlands
| | - J A Castelijns
- From the Departments of Radiology (F.R., P.d.G., M.C.d.J., J.A.C.)
| | - P Galluzzi
- Neuroimaging and Neurointerventional Unit (A.C., P.G.)
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Brisse HJ, de Graaf P, Galluzzi P, Cosker K, Maeder P, Göricke S, Rodjan F, de Jong MC, Savignoni A, Aerts I, Desjardins L, Moll AC, Hadjistilianou T, Toti P, van der Valk P, Castelijns JA, Sastre-Garau X. Assessment of early-stage optic nerve invasion in retinoblastoma using high-resolution 1.5 Tesla MRI with surface coils: a multicentre, prospective accuracy study with histopathological correlation. Eur Radiol 2014; 25:1443-52. [PMID: 25433413 DOI: 10.1007/s00330-014-3514-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 09/20/2014] [Accepted: 11/17/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the accuracy of high-resolution (HR) magnetic resonance imaging (MRI) in diagnosing early-stage optic nerve (ON) invasion in a retinoblastoma cohort. METHODS This IRB-approved, prospective multicenter study included 95 patients (55 boys, 40 girls; mean age, 29 months). 1.5-T MRI was performed using surface coils before enucleation, including spin-echo unenhanced and contrast-enhanced (CE) T1-weighted sequences (slice thickness, 2 mm; pixel size <0.3 × 0.3 mm(2)). Images were read by five neuroradiologists blinded to histopathologic findings. ROC curves were constructed with AUC assessment using a bootstrap method. RESULTS Histopathology identified 41 eyes without ON invasion and 25 with prelaminar, 18 with intralaminar and 12 with postlaminar invasion. All but one were postoperatively classified as stage I by the International Retinoblastoma Staging System. The accuracy of CE-T1 sequences in identifying ON invasion was limited (AUC = 0.64; 95 % CI, 0.55 - 0.72) and not confirmed for postlaminar invasion diagnosis (AUC = 0.64; 95 % CI, 0.47 - 0.82); high specificities (range, 0.64 - 1) and negative predictive values (range, 0.81 - 0.97) were confirmed. CONCLUSION HR-MRI with surface coils is recommended to appropriately select retinoblastoma patients eligible for primary enucleation without the risk of IRSS stage II but cannot substitute for pathology in differentiating the first degrees of ON invasion. KEY POINTS • HR-MRI excludes advanced optic nerve invasion with high negative predictive value. • HR-MRI accurately selects patients eligible for primary enucleation. • Diagnosis of early stages of optic nerve invasion still relies on pathology. • Several physiological MR patterns may mimic optic nerve invasion.
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Hadjistilianou T, Coriolani G, Bracco S, Gennari P, Caini M, Cerase A, Galimberti D, De Francesco S, De Luca M, Mastrangelo D. Successful treatment of macular retinoblastoma with superselective ophthalmic artery infusion of melphalan. J Pediatr Ophthalmol Strabismus 2014; 51:32-8. [PMID: 24308859 DOI: 10.3928/01913913-20131203-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 09/16/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To report our experience with superselective ophthalmic artery infusion of melphalan (SOAIM) for macular retinoblastoma to obtain tumor control while preserving as much useful vision as possible. METHODS Five patients with newly diagnosed unilateral retinoblastoma involving the macula were selected within a group of patients eligible for SOAIM as the primary treatment. RESULTS The mean tumor basal dimension and thickness in this group of five patients with macular retinoblastoma were 11.6 and 12.3 mm, respectively. The stage at diagnosis ranged from II to VB (Reese-Ellsworth) or B to D (International Classification System). Tumor regression with SOAIM was achieved in all cases with regression patterns type I in four cases and III in one case. CONCLUSIONS SOAIM can be of value in the treatment of macular retinoblastoma. It may allow the salvage of the residual eyesight with a low rate of complications due to the local and systemic toxicity related to chemotherapy.
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Bracco S, Leonini S, De Francesco S, Cioni S, Gennari P, Vallone IM, Piu P, Galimberti D, Romano DG, Caini M, De Luca M, Toti P, Galluzzi P, Hadjistilianou T, Cerase A. Intra-arterial chemotherapy with melphalan for intraocular retinoblastoma. Br J Ophthalmol 2013; 97:1219-21. [PMID: 23853166 DOI: 10.1136/bjophthalmol-2013-303267] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Venturi C, Bracco S, Cerase A, Cioni S, Galluzzi P, Gennari P, Vallone IM, Tinturini R, Vittori C, De Francesco S, Caini M, D'Ambrosio A, Toti P, Renieri A, Hadjistilianou T. Superselective ophthalmic artery infusion of melphalan for intraocular retinoblastoma: preliminary results from 140 treatments. Acta Ophthalmol 2013; 91:335-42. [PMID: 22268993 DOI: 10.1111/j.1755-3768.2011.02296.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To report our experience in superselective ophthalmic artery infusion of melphalan (SOAIM) for intraocular retinoblastoma. METHODS From June 2008 to October 2010, 38 patients (18 women, 20 men; age range at first treatment, 7 months to 22 years) with 41 eyes with retinoblastoma were scheduled for SOAIM, for 17 newly diagnosed retinoblastomas Tumour, Node and Metastasis (TNM) 7th Edition 1a (n = 1), 1b (n = 1), 2a (n = 7), 2b (n = 4) and 3a (n = 4) and 24 retinoblastomas with partial remission/relapse TNM 7th Edition 1b (n = 13), 2a (n = 1) and 2b (n = 10). Eight patients (ten eyes) have been treated by SOAIM alone. Follow-up was 6-27 months in 28 patients (30 eyes). RESULTS Ophthalmic artery cannulation failed in two patients. Thirty-six patients underwent 140 treatments by internal (n = 112) or external (n = 28) carotid arteries. No major procedural complications occurred. Two patients have been lost to follow-up. Remaining 34 patients (37 eyes) had no metastatic disease. Four patients suffered permanent ocular complications: chorioretinal dystrophy (n = 2), ptosis (n = 1) and strabismus/exotropia (n = 1). Eight (22%) eyes in eight (24%) patients underwent enucleation: 7/16 (43%) newly diagnosed retinoblastomas and 1/22 (4.5%) retinoblastomas undergoing partial remission/relapse. For all treated eyes, Kaplan-Meier eye enucleation-free rates (K-M) were 85.4% (95% CI, 73.3-97.5%), 74.4% (95% CI, 57-91.8%) and still stable at 6, 12 months and 2 years, respectively. For eyes with partial remission/relapse, and eyes at presentation, K-M at 2 years were 95.5% (95% CI, 86.9-100%) and 45.6% (95% CI, 16.6-74.6%), respectively. CONCLUSION Superselective ophthalmic artery infusion of melphalan was safe and powerful, especially following other therapies. Superselective ophthalmic artery infusion of melphalan should be added to focal therapies spectrum. In selected cases, melphalan should be combined with other chemotherapeutic agents.
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Affiliation(s)
- Carlo Venturi
- Unit NINT Neuroimaging and Neurointervention, Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Siena, Italy.
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Pichi F, Lembo A, De Luca M, Hadjistilianou T, Nucci P. Bilateral retinoblastoma: clinical presentation, management and treatment. Int Ophthalmol 2013; 33:589-93. [PMID: 23277210 DOI: 10.1007/s10792-012-9703-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 12/19/2012] [Indexed: 12/01/2022]
Abstract
Management of retinoblastoma (Rb), the most common intraocular malignant tumor in childhood, is tailored to each individual case and based on the overall situation. We present a case of bilateral Rbs in a 4-month-old girl, referred to our center for bilateral leukocoria. In the right eye, the optic disc was partially visible, and three large foci of retinoblastoma were noted adjective in the vitreous cavity with satellite retinal detachment. The macula was obscured by the tumors. The tumor was therefore classified as group D (International classification of retinoblastoma), and thus underwent intravenous chemotherapy with the standard three-agent protocol of ifosfamide, carboplatin and etoposide (ICE protocol) delivered monthly for six cycles, regressing with a type I calcified pattern. The left eye presented three multifocal yellow-white retinal masses, with a total retinal detachment, and secondary glaucoma. The lesions were classified as group E and, therefore, taking the results obtained by Shields et al. in group E tumors into consideration, underwent enucleation. This case clearly shows that this cancer is curable if detected at a stage in which it is still contained within the retina, subretinal space or vitreous, and that the management of Rb relies on an experienced team of ocular oncologists, pediatricians and pediatric ophthalmologists working together for the single goal of saving the child's life.
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Affiliation(s)
- Francesco Pichi
- San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, 20123, Milan, Italy,
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Livide G, Epistolato MC, Amenduni M, Disciglio V, Marozza A, Mencarelli MA, Toti P, Lazzi S, Hadjistilianou T, De Francesco S, D'Ambrosio A, Renieri A, Ariani F. Epigenetic and copy number variation analysis in retinoblastoma by MS-MLPA. Pathol Oncol Res 2012; 18:703-12. [PMID: 22278416 DOI: 10.1007/s12253-012-9498-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 01/03/2012] [Indexed: 12/31/2022]
Abstract
Retinoblastoma is the most common primary intraocular malignancy in children. Two step inactivation of RB1 (M1-M2) represents the key event in the pathogenesis of retinoblastoma but additional genetic and epigenetic events (M3-Mn) are required for tumor development. In the present study, we employed Methylation Specific Multiplex Ligation Probe Assay to investigate methylation status and copy number changes of 25 and 39 oncosuppressor genes, respectively. This technique was applied to analyse 12 retinoblastomas (5 bilateral and 7 unilateral) and results were compared to corresponding normal retina. We identified hypermethylation in seven new genes: MSH6 (50%), CD44 (42%), PAX5 (42%), GATA5 (25%), TP53 (8%), VHL (8%) and GSTP1 (8%) and we confirmed the previously reported hypermethylation of MGMT (58%), RB1 (17%) and CDKN2 (8%). These genes belong to key pathways including DNA repair, pRB and p53 signalling, transcriptional regulation, protein degradation, cell-cell interaction, cellular adhesion and migration. In the same group of retinoblastomas, a total of 29 copy number changes (19 duplications and 10 deletions) have been identified. Interestingly, we found deletions of the following oncosuppressor genes that might contribute to drive retinoblastoma tumorigenesis: TP53, CDH13, GATA5, CHFR, TP73 and IGSF4. The present data highlight the importance of epigenetic changes in retinoblastoma and indicate seven hypermethylated oncosuppressors never associated before to retinoblastoma pathogenesis. This study also confirms the presence of copy number variations in retinoblastoma, expecially in unilateral cases (mean 3 ± 1.3) where these changes were found more frequently respect to bilateral cases (mean 1.4 ± 1.1).
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Hadjistilianou T, Giglioni S, Micheli L, Vannoni D, Brogi E, Cevenini G, Cortelazzo A, De Francesco S, Menicacci F, Leoncini R. Analysis of aqueous humour proteins in patients with retinoblastoma. Clin Exp Ophthalmol 2011; 40:e8-e15. [PMID: 22003840 DOI: 10.1111/j.1442-9071.2011.02711.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND To investigate aqueous humour protein composition from retinoblastoma patients. DESIGN Prospective, hospital-based study. PARTICIPANTS Eighteen retinoblastoma patients (Reese-Ellsworth stage V or ABC classification group E RB) undergoing ocular enucleation, and 10 normal subjects undergoing cataract surgery. Five of 18 patients presented with associated secondary glaucoma whereas 13 had no secondary glaucoma; 5 of 13 patients with no secondary glaucoma received chemotherapeutical treatment with melphalan. METHODS Aqueous humour samples were collected by limbal paracentesis of the anterior chamber after ocular enucleation in patients and after the stab peripheral corneal incision in controls. Total protein concentration according to Bradford method and sodium dodecyl sulphate-polyacrylamide gel electrophoresis of the samples were performed. MAIN OUTCOME MEASURE Aqueous humour protein concentration. RESULTS Aqueous humour protein concentration was significantly higher in retinoblastoma patients than controls (P < 0.01); patients with secondary glaucoma presented the highest values (P < 0.05 vs. controls); patients treated with melphalan presented a significant decrease (P < 0.01) versus non-treated; controls did not significantly differ from treated patients. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis pattern in retinoblastoma patients who did not receive any treatment was very different either from treated or from controls. CONCLUSION This study represents a preliminary step towards a more accurate two dimensional electrophoresis (2DE) pattern, which will be combined with mass spectrometry analysis to clarify the potential role of specific proteins in tumour development and progression; although these results suggest that aqueous humour protein pattern in retinoblastoma is characteristic, several aspects of the study are still under investigation.
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Epistolato MC, Disciglio V, Livide G, Berchialla P, Mencarelli MA, Marozza A, Amenduni M, Hadjistilianou T, De Francesco S, Acquaviva A, Toti P, Cetta F, Ariani F, De Marchi M, Renieri A, Giachino D. p53 Arg72Pro and MDM2 309 SNPs in hereditary retinoblastoma. J Hum Genet 2011; 56:685-6. [DOI: 10.1038/jhg.2011.82] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Indovina P, Acquaviva A, De Falco G, Rizzo V, Onnis A, Luzzi A, Giorgi F, Hadjistilianou T, Toti P, Tomei V, Pentimalli F, Carugi A, Giordano A. Downregulation and aberrant promoter methylation of p16INK4A: a possible novel heritable susceptibility marker to retinoblastoma. J Cell Physiol 2010; 223:143-50. [PMID: 20039270 DOI: 10.1002/jcp.22019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
RB loss has long been recognized as the causative genetic alteration underlying retinoblastoma but it is increasingly evident that other alterations are required for the tumor to develop. Therefore, we set out to identify additional inheritable susceptibility markers and new potential preventive and therapeutic targets for retinoblastoma. We focused on the p16INK4A tumor suppressor gene because of its possible role in retinoblastoma pathogenesis and its involvement in predisposition to familial cancer. p16INK4A expression was analyzed in tumor samples from retinoblastoma patients by immunohistochemistry and in peripheral blood cells from both patients and their parents by real-time quantitative reverse transcription-PCR (qRT-PCR). Since promoter methylation is a common mechanism regulating p16INK4A expression, the methylation status of its promoter was also analyzed in blood samples from patients and their parents by methylation-specific PCR. A downregulation of p16INK4A was observed in 55% of retinoblastoma patients. Interestingly, in 56% of the cases showing p16INK4A downregulation at least one of the patients' parents bore the same alteration in blood cells. Analysis of p16INK4A promoter methylation showed hypermethylation in most patients with p16INK4A downregulation and in the parents with the same alteration in p16INK4A expression. The finding that p16INK4A was downregulated both in patients and their parents suggests that this alteration could be a novel inheritable susceptibility marker to retinoblastoma. The observation that p16INK4A downregulation seems to be due to its promoter hypermethylation opens the way for the development of new preventive and therapeutic strategies using demethylating agents.
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Affiliation(s)
- Paola Indovina
- Department of Human Pathology and Oncology, University of Siena, Siena, Italy
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Cerase A, De Francesco S, Citterio A, Hadjistilianou T, Malandrini A, Mastrangelo D, Toti P, Venturi C. Growth of congenital malignant teratoid medulloepithelioma of the ciliary body: a case study. J Neurooncol 2009; 96:443-8. [PMID: 19669095 DOI: 10.1007/s11060-009-9982-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Accepted: 07/21/2009] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to describe the growth pattern of congenital malignant teratoid medulloepithelioma of the ciliary body by reporting clinical and imaging findings with pathological correlation. An 11-month-old little girl presented with a whitish-pink iris mass in the right eye resulting from a small ciliary body mass consistent with medulloepithelioma at both clinical and computed tomography (CT) findings. At CT, the lesion showed heterogeneous attenuation, without intraocular calcifications. Eleven months later, clinical and ultrabiomicroscopy showed a clear enlargement of the mass, which invaded the pupil. At magnetic resonance imaging (MRI), the lesion showed T1-weighted hyperintensity and T2-weighted slight hypointensity when compared to the vitreous and a notch in the anterolateral aspect of the ipsilateral lens. After intravenous gadolinium administration, the lesion showed intense homogeneous enhancement, and there was leakage of gadolinium in the anterior chamber, resulting from impairment of blood-aqueous barrier. Biopsy revealed a malignant teratoid medulloepithelioma. The eye was then enucleated, and histology confirmed the diagnosis. Systemic chemotherapy and radiotherapy were not performed, since there was no extraocular extension. The 57-month clinical and MRI follow-up did not show disease relapse. This uncommon case displays the natural history of congenital malignant teratoid medulloepithelioma of the ciliary body. While the tumour might have been successfully treated by local excision at diagnosis, the delay in surgical treatment led to tumour overgrowth with consequent need for enucleation. The most important prognostic feature is extraocular extension, which carries a risk of local recurrence, eventually resulting in intracranial extension and/or lymphatic spread.
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Affiliation(s)
- Alfonso Cerase
- Unit of Neuroimaging and Neurointervention, Department of Neurosciences and the Interdepartmental Center of Nuclear Magnetic Resonance, Azienda Ospedaliera Universitaria Senese, Santa Maria alle Scotte General Hospital, Viale Mario Bracci, 16, 53100, Siena, Italy.
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Galluzzi P, Hadjistilianou T, Cerase A, De Francesco S, Toti P, Venturi C. Is CT still useful in the study protocol of retinoblastoma? AJNR Am J Neuroradiol 2009; 30:1760-5. [PMID: 19617447 DOI: 10.3174/ajnr.a1716] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intralesional calcium deposition is considered a key element for differentiating retinoblastoma from simulating lesions. Our aim was to assess whether MR imaging associated with ophthalmologic investigations (ophthalmoscopy and ultrasonography) could replace CT in the detection of diagnostic intralesional calcifications in retinoblastoma. MATERIALS AND METHODS Ophthalmoscopic findings, MR images, CT scans, and histologic examination of 28 retinoblastomas from 23 consecutive children (11 males, 12 females; age range at admission, 1-35 months; mean age, 11 months; median age, 9 months) were retrospectively evaluated. Ultrasonography was performed in 18 patients with 21 retinoblastomas. MR imaging included T2-weighted spin-echo and gradient-echo images, fluid-attenuated inversion recovery images, and T1-weighted spin-echo images with and without contrast enhancement. Clinical data were integrated with MR imaging data to evaluate the utility of both approaches to discover calcifications; particularly, a correlation between intralesional signal-intensity void spots on MR imaging and hyperattenuating areas on CT scans was performed. RESULTS Ophthalmoscopy detected calcifications in 12 of 28 eyes (42.85%). Ultrasonography detected calcifications in 20 of 21 eyes (95.23%). CT showed hyperattenuating intralesional areas consistent with calcifications in 27 of 28 eyes (96.42%). MR imaging showed intralesional signal-intensity void spots in 25 of 28 eyes (89.28%). All spots detected with MR imaging matched the presence of calcifications on CT scans. Gradient-echo T2*-weighted and fast spin-echo T2-weighted images showed the highest degree of correlation with CT. When we put together ophthalmoscopy, ultrasonography, and MR imaging data, no calcifications detected on CT were missed, and the differential diagnosis was thorough. CONCLUSIONS A combination of clinical data and MR images may remove potentially harmful ionizing radiation from the study protocol of retinoblastoma.
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Affiliation(s)
- P Galluzzi
- Unit of Diagnostic and Therapeutic Neuroradiology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
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Sampieri K, Mencarelli MA, Carmela Epistolato M, Toti P, Lazzi S, Bruttini M, Francesco SD, Longo I, Meloni I, Mari F, Acquaviva A, Hadjistilianou T, Renieri A, Ariani F. Genomic differences between retinoma and retinoblastoma. Acta Oncol 2009; 47:1483-92. [PMID: 18785023 DOI: 10.1080/02841860802342382] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Genomic copy number changes are involved in the multi-step process transforming normal retina in retinoblastoma after RB1 mutational events. Previous studies on retinoblastoma samples led to a multi-step model in which after two successive RB1 mutations, further genomic changes accompany malignancy: 1q32.1 gain is followed by 6p22 gain, that in turn is followed by 16q22 loss and 2p24.1 gain. Retinoma is a benign variant of retinoblastoma that was initially considered a tumor regression, but recent evidences suggest that it rather represents a pre-malignant lesion. Genetic studies on retinoma tissue have rarely been performed. MATERIALS AND METHODS We investigated by Real-Time qPCR, copy number changes of candidate genes located within the 4 hot-spot regions (MDM4 at 1q32.1, MYCN at 2p24.1, E2F3 at 6p22 and CDH11 at 16q22) in retina, retinoma and retinoblastoma tissues from two different patients. RESULTS Our results demonstrated that some copy number changes thought to belong to early (MDM4 gain) or late stage (MYCN and E2F3 gain) of retinoblastoma are already present in retinoma at the same (for MDM4) or at lower (for MYCN and E2F3) copy number variation respect to retinoblastoma. CDH11 copy number is not altered in the two retinoma samples, but gain is present in one of the two retinoblastomas. DISCUSSION Our results suggest that MDM4 gain may be involved in the early transition from normal retina to retinoma, while MYCN and E2F3 progressive gain may represent driving factors of tumor progression. These results also confirm the pre-malignant nature of retinoma.
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