Purpose: To evaluate the efficacy of subtenon injection of carboplatin in the management of intraocular retinoblastoma in patients referred to Farabi Eye Hospital.
Methods: The study was a randomized double blind matched clinical trial. Definite diagnosis of intraocular retinoblastoma was made based on clinical examination, ultrasonography, and orbit CT-scanning. A comprehensive ocular examination was performed with the patient under anesthesia. The greatest basal diameter and the thickness (elevation) of the turners were estimated through indirect ophthalmoscopy in disc diameter (DD). After excluding extraocular spreading of the tumor, each eye was assigned to one of 10 blocks based on tumor stage (Reese-Ellsworth classification) and randomly received either systemic chemotherapy alone (control group) or systemic chemotherapy with subtenon carboplatin (case group). During follow up examinations, the size of tumor was checked. Adjuvant treatment or enucleation was performed if needed.
Results: The study included 35 tumors in 17 eyes of 13 patients including 19 tumors in 8 eyes in the control group and 16turners in 9 eyes in the case group. At final examination there was a 46.92% decrease in tumor thickness at funduscopy in the control group versus 63.12% in case group (P=0.12). The decrease in greatest tumor diameter in the control group (47.32%) was not significantly different from that in the case group (38.80%). The decrease in thickness on echography in the control group (57.22%) did not differ significantly from that in the case group (61.73%). One eye (12.5%) in the control group and 3 eyes (33.3%) in the case group were enucleated.
Conclusion: Subtenon carboplatin does not seem to increase the efficacy of systemicchemotherapy for the treatment of intraocular retinoblastoma.