The Experts below are selected from a list of 174 Experts worldwide ranked by ideXlab platform
David H Abramson - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of massive choroidal invasion in retinoblastoma with intra arterial chemotherapy ophthalmic artery Chemosurgery
Ophthalmology Retina, 2020Co-Authors: Jasmine H Francis, Pierre Y Gobin, Ira J Dunkel, David H AbramsonAbstract:Abstract Retinoblastoma eyes with choroidal invasion may not have to be enucleated and may be successfully managed with OAC using Melphalan, Carboplatin and Topotecan without compromising patient survival.
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association of electroretinography with visual outcomes after ophthalmic artery Chemosurgery for retinoblastoma in icrb d and e eyes
PLOS ONE, 2019Co-Authors: Jasmine H Francis, Pierre Y Gobin, Scott E Brodie, David H Abramson, Ariana M. Levin, Molly McfaddenAbstract:Importance Predictions of visual outcomes are useful in clinical and family decisions regarding treatment for retinoblastoma. Very little has been published on the association of post-treatment visual acuity with pre-treatment electroretinography (ERG), which can be performed on infants too young to reliably quantify visual acuity. Objective To report associations of pre-treatment ERG with post-treatment visual acuity in eyes with advanced retinoblastoma treated with ophthalmic artery Chemosurgery (OAC). Design Retrospective case-control study of eyes treated from 2006 through 2017, with mean follow-up of 51 months (range 2.3–150 months). Setting Single large academic center. Participants Group D and E eyes treated with OAC at Memorial Sloan Kettering Cancer Center with recorded visual acuity and ERG (30Hz flicker). Main outcome and measure Snellen visual acuity (uncorrected) compared to initial 30Hz flicker ERG. Results This study included 157 Group D and E eyes. Results of the Jonckheere-Terpstra test for trend were statistically significant and indicated that eyes with lower pre-treatment ERG readings tended to have more visual impairment post-treatment. Among eyes with initial ERG 75+ μV, 11 of 32 eyes (34%) had visual acuity 20/40 or better. Among eyes with ERG 0 μV, 44 of 46 (96%) had visual acuity of 20/200 or worse. Conclusions and relevance Eyes with advanced intraocular retinoblastoma treated with OAC can achieve excellent visual acuity, but poor ERG at initial visit is associated with poor visual acuity after treatment in the majority of eyes. Expectations regarding visual potential may influence decisions about treatment.
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Visual acuity after ophthalmic artery Chemosurgery (OAC) for retinoblastoma, grouped by ERG at initial clinic visit.
2019Co-Authors: Ariana M. Levin, Jasmine H Francis, Pierre Y Gobin, Molly Mcfadden, Scott Brodie, David H AbramsonAbstract:Visual acuity after ophthalmic artery Chemosurgery (OAC) for retinoblastoma, grouped by ERG at initial clinic visit.
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ten year experience with ophthalmic artery Chemosurgery ocular and recurrence free survival
PLOS ONE, 2018Co-Authors: Jasmine H Francis, Pierre Y Gobin, David H Abramson, Ariana M. Levin, Emily C ZaborAbstract:Purpose To report associations between disease- and treatment-related variables and rates of recurrence-free survival and ocular survival in eyes treated with ophthalmic artery Chemosurgery (OAC) for retinoblastoma. Design Pre-post study. Subjects All eyes treated with OAC for retinoblastoma at Memorial Sloan Kettering Cancer Center between May 2006 and February 2017. Methods This retrospective review included 452 retinoblastoma eyes treated with OAC. The Kaplan-Meier method was used to estimate recurrence-free survival (RFS), progression-free survival (PFS) and ocular survival (OcS), and Cox regression was used to estimate hazard ratios. Eyes treated in the pre-intravitreous chemotherapy era were analyzed separately from eyes treated in the intravitreal era. Main outcome measures Recurrence-free survival, ocular survival, associations with risk of recurrence. Results Disease and treatment characteristics were recorded over a median 23.6 month follow-up. One-year OcS, PFS and RFS were 96% (95% CI 93-99%), 88% (95% CI 88-94%) and 74% (95% CI 67-81%) in the pre-intravitreal era and 96% (95% CI 94-99%), 93% (95% CI 89-96%) and 78% (95% CI 72-83%) in the intravitreal era, respectively. Presence of vitreous seeds was associated with increased risk of recurrence in the pre-intravitreal era but not in the intravitreal era. Longer time interval between OAC sessions was associated with increased risk of recurrence and majority OAC access via the ophthalmic artery was associated with decreased risk of recurrence in both eras. Conclusions Approximately a quarter of eyes initially treated with ophthalmic artery Chemosurgery develop recurrent disease, with the majority of recurrences within the first year following completion of OAC. Despite this, these eyes have a very good chance of salvage. In eyes with vitreous seeds at presentation, intravitreal injections are useful in minimizing future vitreous recurrence. Eyes that receive the majority of drug infusions via non-ophthalmic artery routes or greater interval between OAC are more likely to recur and might warrant closer monitoring.
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total retinal detachments due to retinoblastoma outcomes following intra arterial chemotherapy ophthalmic artery Chemosurgery
PLOS ONE, 2018Co-Authors: Megan Rowlands, Jasmine H Francis, Pierre Y Gobin, Ira J Dunkel, Scott E Brodie, Ariana M. Levin, Ijah Mondesirecrump, Audrey Mauguen, David H AbramsonAbstract:PURPOSE To report on the rate and timing of retinal reattachment and outcomes for retinoblastoma children who have total retinal detachments at presentation to our center and were treated with intra-arterial chemotherapy (ophthalmic artery Chemosurgery, OAC). PATIENTS AND METHODS Single-center retrospective review of retinoblastoma patients who presented with total retinal detachments and were subsequently treated with OAC at MSKCC between May 2006 and July 2016. Endpoints were retinal detachment resolution, visual function, ERG amplitude, ocular survival, and patient survival from metastases. RESULTS 87 eyes of 84 retinoblastoma patients were included. Using a survival multistate model, by 36 months of follow-up, there was a 54% cumulative probability of complete retinal reattachment and a 76% probability of partial reattachment. 24% of eyes that completely reattached received only OAC without any prior or adjuvant treatments. Eyes that completely reattached were significantly more likely to have been diagnosed at a younger age (p<0.0001) and to have greater initial ERG values (p = 0.006). At final follow-up, 14% of eyes had gained at least 25 μV of ERG activity, and 8.0% had achieved hand motion vision or better, including one to 20/60. 13% of eyes were enucleated. No patient died from metastatic disease, and only one developed metastases. CONCLUSION OAC can successfully treat previously considered "non-salvageable" retinoblastoma eyes with total retinal detachments, promote retinal reattachment in the majority of eyes, and preserve ocular and patient survival.
Pierre Y Gobin - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of massive choroidal invasion in retinoblastoma with intra arterial chemotherapy ophthalmic artery Chemosurgery
Ophthalmology Retina, 2020Co-Authors: Jasmine H Francis, Pierre Y Gobin, Ira J Dunkel, David H AbramsonAbstract:Abstract Retinoblastoma eyes with choroidal invasion may not have to be enucleated and may be successfully managed with OAC using Melphalan, Carboplatin and Topotecan without compromising patient survival.
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association of electroretinography with visual outcomes after ophthalmic artery Chemosurgery for retinoblastoma in icrb d and e eyes
PLOS ONE, 2019Co-Authors: Jasmine H Francis, Pierre Y Gobin, Scott E Brodie, David H Abramson, Ariana M. Levin, Molly McfaddenAbstract:Importance Predictions of visual outcomes are useful in clinical and family decisions regarding treatment for retinoblastoma. Very little has been published on the association of post-treatment visual acuity with pre-treatment electroretinography (ERG), which can be performed on infants too young to reliably quantify visual acuity. Objective To report associations of pre-treatment ERG with post-treatment visual acuity in eyes with advanced retinoblastoma treated with ophthalmic artery Chemosurgery (OAC). Design Retrospective case-control study of eyes treated from 2006 through 2017, with mean follow-up of 51 months (range 2.3–150 months). Setting Single large academic center. Participants Group D and E eyes treated with OAC at Memorial Sloan Kettering Cancer Center with recorded visual acuity and ERG (30Hz flicker). Main outcome and measure Snellen visual acuity (uncorrected) compared to initial 30Hz flicker ERG. Results This study included 157 Group D and E eyes. Results of the Jonckheere-Terpstra test for trend were statistically significant and indicated that eyes with lower pre-treatment ERG readings tended to have more visual impairment post-treatment. Among eyes with initial ERG 75+ μV, 11 of 32 eyes (34%) had visual acuity 20/40 or better. Among eyes with ERG 0 μV, 44 of 46 (96%) had visual acuity of 20/200 or worse. Conclusions and relevance Eyes with advanced intraocular retinoblastoma treated with OAC can achieve excellent visual acuity, but poor ERG at initial visit is associated with poor visual acuity after treatment in the majority of eyes. Expectations regarding visual potential may influence decisions about treatment.
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Visual acuity after ophthalmic artery Chemosurgery (OAC) for retinoblastoma, grouped by ERG at initial clinic visit.
2019Co-Authors: Ariana M. Levin, Jasmine H Francis, Pierre Y Gobin, Molly Mcfadden, Scott Brodie, David H AbramsonAbstract:Visual acuity after ophthalmic artery Chemosurgery (OAC) for retinoblastoma, grouped by ERG at initial clinic visit.
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ten year experience with ophthalmic artery Chemosurgery ocular and recurrence free survival
PLOS ONE, 2018Co-Authors: Jasmine H Francis, Pierre Y Gobin, David H Abramson, Ariana M. Levin, Emily C ZaborAbstract:Purpose To report associations between disease- and treatment-related variables and rates of recurrence-free survival and ocular survival in eyes treated with ophthalmic artery Chemosurgery (OAC) for retinoblastoma. Design Pre-post study. Subjects All eyes treated with OAC for retinoblastoma at Memorial Sloan Kettering Cancer Center between May 2006 and February 2017. Methods This retrospective review included 452 retinoblastoma eyes treated with OAC. The Kaplan-Meier method was used to estimate recurrence-free survival (RFS), progression-free survival (PFS) and ocular survival (OcS), and Cox regression was used to estimate hazard ratios. Eyes treated in the pre-intravitreous chemotherapy era were analyzed separately from eyes treated in the intravitreal era. Main outcome measures Recurrence-free survival, ocular survival, associations with risk of recurrence. Results Disease and treatment characteristics were recorded over a median 23.6 month follow-up. One-year OcS, PFS and RFS were 96% (95% CI 93-99%), 88% (95% CI 88-94%) and 74% (95% CI 67-81%) in the pre-intravitreal era and 96% (95% CI 94-99%), 93% (95% CI 89-96%) and 78% (95% CI 72-83%) in the intravitreal era, respectively. Presence of vitreous seeds was associated with increased risk of recurrence in the pre-intravitreal era but not in the intravitreal era. Longer time interval between OAC sessions was associated with increased risk of recurrence and majority OAC access via the ophthalmic artery was associated with decreased risk of recurrence in both eras. Conclusions Approximately a quarter of eyes initially treated with ophthalmic artery Chemosurgery develop recurrent disease, with the majority of recurrences within the first year following completion of OAC. Despite this, these eyes have a very good chance of salvage. In eyes with vitreous seeds at presentation, intravitreal injections are useful in minimizing future vitreous recurrence. Eyes that receive the majority of drug infusions via non-ophthalmic artery routes or greater interval between OAC are more likely to recur and might warrant closer monitoring.
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growth patterns of survivors of retinoblastoma treated with ophthalmic artery Chemosurgery
PLOS ONE, 2018Co-Authors: Sruti S Akella, Jasmine H Francis, Pierre Y Gobin, Edith Guarini, Lindsey Eibeler, Andrea Knezevic, Irina Ostrovnaya, Danielle Novetsky Friedman, Federica CatalanottiAbstract:Although studies from pediatric cancers (largely acute lymphoblastic leukemia) have shown that patients undergoing systemic chemotherapy may experience decreased growth velocity during the treatment phase, no such data exist for retinoblastoma patients treated with systemic chemotherapy or ophthalmic artery Chemosurgery (OAC). The purpose of this study is to report growth patterns of our retinoblastoma (Rb) population who were treated with OAC in a retrospective, single center (Memorial Sloan Kettering Cancer Center) review of 341 patients treated between 2006 and 2016. Children who only received OAC were classified as naive; those who were treated initially with systemic chemotherapy and subsequently presented to our center for OAC were termed secondary; and a small group of patients who received single-agent systemic chemotherapy prior to OAC were labeled bridge. For all patients, height and weight were recorded at monthly intervals during OAC (short-term) and then annually during a follow-up period (long-term) up to 3 years after treatment. Excluded from this study were children who received external radiation therapy and those with genetic syndromes, which are independently associated with growth derangements. During OAC, there was no significant difference in growth velocity between the naive and secondary groups. In either group, number of treatments also did not affect growth rate. Three years after the end of OAC, naive patients were in the 68th percentile by height (95% CI 61.30, 74.63) compared to secondary patients in the 61st percentile (95% CI 51.1, 71.47). Both groups were in the same weight percentiles during the first two years of follow-up but at the three-year follow-up period, naive patients were in the 63rd percentile (95% CI 57.4, 69.4) and secondary patients were in the 60th percentile (95% CI 50.4, 69.7). OAC for retinoblastoma does not appear to impact short-term growth velocity, weight gain during the treatment period or after three years.
Jasmine H Francis - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of massive choroidal invasion in retinoblastoma with intra arterial chemotherapy ophthalmic artery Chemosurgery
Ophthalmology Retina, 2020Co-Authors: Jasmine H Francis, Pierre Y Gobin, Ira J Dunkel, David H AbramsonAbstract:Abstract Retinoblastoma eyes with choroidal invasion may not have to be enucleated and may be successfully managed with OAC using Melphalan, Carboplatin and Topotecan without compromising patient survival.
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association of electroretinography with visual outcomes after ophthalmic artery Chemosurgery for retinoblastoma in icrb d and e eyes
PLOS ONE, 2019Co-Authors: Jasmine H Francis, Pierre Y Gobin, Scott E Brodie, David H Abramson, Ariana M. Levin, Molly McfaddenAbstract:Importance Predictions of visual outcomes are useful in clinical and family decisions regarding treatment for retinoblastoma. Very little has been published on the association of post-treatment visual acuity with pre-treatment electroretinography (ERG), which can be performed on infants too young to reliably quantify visual acuity. Objective To report associations of pre-treatment ERG with post-treatment visual acuity in eyes with advanced retinoblastoma treated with ophthalmic artery Chemosurgery (OAC). Design Retrospective case-control study of eyes treated from 2006 through 2017, with mean follow-up of 51 months (range 2.3–150 months). Setting Single large academic center. Participants Group D and E eyes treated with OAC at Memorial Sloan Kettering Cancer Center with recorded visual acuity and ERG (30Hz flicker). Main outcome and measure Snellen visual acuity (uncorrected) compared to initial 30Hz flicker ERG. Results This study included 157 Group D and E eyes. Results of the Jonckheere-Terpstra test for trend were statistically significant and indicated that eyes with lower pre-treatment ERG readings tended to have more visual impairment post-treatment. Among eyes with initial ERG 75+ μV, 11 of 32 eyes (34%) had visual acuity 20/40 or better. Among eyes with ERG 0 μV, 44 of 46 (96%) had visual acuity of 20/200 or worse. Conclusions and relevance Eyes with advanced intraocular retinoblastoma treated with OAC can achieve excellent visual acuity, but poor ERG at initial visit is associated with poor visual acuity after treatment in the majority of eyes. Expectations regarding visual potential may influence decisions about treatment.
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Visual acuity after ophthalmic artery Chemosurgery (OAC) for retinoblastoma, grouped by ERG at initial clinic visit.
2019Co-Authors: Ariana M. Levin, Jasmine H Francis, Pierre Y Gobin, Molly Mcfadden, Scott Brodie, David H AbramsonAbstract:Visual acuity after ophthalmic artery Chemosurgery (OAC) for retinoblastoma, grouped by ERG at initial clinic visit.
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ten year experience with ophthalmic artery Chemosurgery ocular and recurrence free survival
PLOS ONE, 2018Co-Authors: Jasmine H Francis, Pierre Y Gobin, David H Abramson, Ariana M. Levin, Emily C ZaborAbstract:Purpose To report associations between disease- and treatment-related variables and rates of recurrence-free survival and ocular survival in eyes treated with ophthalmic artery Chemosurgery (OAC) for retinoblastoma. Design Pre-post study. Subjects All eyes treated with OAC for retinoblastoma at Memorial Sloan Kettering Cancer Center between May 2006 and February 2017. Methods This retrospective review included 452 retinoblastoma eyes treated with OAC. The Kaplan-Meier method was used to estimate recurrence-free survival (RFS), progression-free survival (PFS) and ocular survival (OcS), and Cox regression was used to estimate hazard ratios. Eyes treated in the pre-intravitreous chemotherapy era were analyzed separately from eyes treated in the intravitreal era. Main outcome measures Recurrence-free survival, ocular survival, associations with risk of recurrence. Results Disease and treatment characteristics were recorded over a median 23.6 month follow-up. One-year OcS, PFS and RFS were 96% (95% CI 93-99%), 88% (95% CI 88-94%) and 74% (95% CI 67-81%) in the pre-intravitreal era and 96% (95% CI 94-99%), 93% (95% CI 89-96%) and 78% (95% CI 72-83%) in the intravitreal era, respectively. Presence of vitreous seeds was associated with increased risk of recurrence in the pre-intravitreal era but not in the intravitreal era. Longer time interval between OAC sessions was associated with increased risk of recurrence and majority OAC access via the ophthalmic artery was associated with decreased risk of recurrence in both eras. Conclusions Approximately a quarter of eyes initially treated with ophthalmic artery Chemosurgery develop recurrent disease, with the majority of recurrences within the first year following completion of OAC. Despite this, these eyes have a very good chance of salvage. In eyes with vitreous seeds at presentation, intravitreal injections are useful in minimizing future vitreous recurrence. Eyes that receive the majority of drug infusions via non-ophthalmic artery routes or greater interval between OAC are more likely to recur and might warrant closer monitoring.
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growth patterns of survivors of retinoblastoma treated with ophthalmic artery Chemosurgery
PLOS ONE, 2018Co-Authors: Sruti S Akella, Jasmine H Francis, Pierre Y Gobin, Edith Guarini, Lindsey Eibeler, Andrea Knezevic, Irina Ostrovnaya, Danielle Novetsky Friedman, Federica CatalanottiAbstract:Although studies from pediatric cancers (largely acute lymphoblastic leukemia) have shown that patients undergoing systemic chemotherapy may experience decreased growth velocity during the treatment phase, no such data exist for retinoblastoma patients treated with systemic chemotherapy or ophthalmic artery Chemosurgery (OAC). The purpose of this study is to report growth patterns of our retinoblastoma (Rb) population who were treated with OAC in a retrospective, single center (Memorial Sloan Kettering Cancer Center) review of 341 patients treated between 2006 and 2016. Children who only received OAC were classified as naive; those who were treated initially with systemic chemotherapy and subsequently presented to our center for OAC were termed secondary; and a small group of patients who received single-agent systemic chemotherapy prior to OAC were labeled bridge. For all patients, height and weight were recorded at monthly intervals during OAC (short-term) and then annually during a follow-up period (long-term) up to 3 years after treatment. Excluded from this study were children who received external radiation therapy and those with genetic syndromes, which are independently associated with growth derangements. During OAC, there was no significant difference in growth velocity between the naive and secondary groups. In either group, number of treatments also did not affect growth rate. Three years after the end of OAC, naive patients were in the 68th percentile by height (95% CI 61.30, 74.63) compared to secondary patients in the 61st percentile (95% CI 51.1, 71.47). Both groups were in the same weight percentiles during the first two years of follow-up but at the three-year follow-up period, naive patients were in the 63rd percentile (95% CI 57.4, 69.4) and secondary patients were in the 60th percentile (95% CI 50.4, 69.7). OAC for retinoblastoma does not appear to impact short-term growth velocity, weight gain during the treatment period or after three years.
Brian P Marr - One of the best experts on this subject based on the ideXlab platform.
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selective ophthalmic artery Chemosurgery soac for retinoblastoma fluoroscopic time and radiation dose parameters a baseline study
Journal of NeuroInterventional Surgery, 2017Co-Authors: Srikanth R Boddu, Jasmine H Francis, Brian P Marr, David H Abramson, Pierre Y GobinAbstract:Objective To evaluate fluoroscopic time and radiation dose parameters, and factors affecting these parameters, during selective ophthalmic artery Chemosurgery (SOAC) for retinoblastoma. Materials and methods Retrospective review from the prospective database of all patients with retinoblastoma treated with SOAC over a 5-year period (September 2009–January 2015) at a single institution after receiving institutional review board approval. Patient demographics, arterial approach, access device, side of treatment, number of SOAC cycles/patient, number of drugs/SOAC, and radiation parameters (outcome variables), including the fluoroscopic time, dose–area product (DAP), and total radiation dose, were obtained from the database. Generalized linear regression was used for univariate and multivariate analysis of the outcome variables. Results In 218 patients (M:F=94:124), 272 eyes were treated by 833 SOAC infusions during 792 procedures. Mean age, weight, SOAC cycle/patient, and drugs/cycle were 19±19.5 months, 11.4±6.4 kg, 2.72±1.6, and 2.48±0.8, respectively. Mean fluoroscopic time, DAP, and doses were 10.2±8.4 min, 218.7±240.8 cGy.cm 2 , and 42.3±41.4 mGy, respectively. Radiation parameters (fluoroscopic time, DAP, and dose) were significantly lower (p Conclusions In SOAC for retinoblastoma, the OA approach, microcatheter access, and unilateral treatment were associated with significantly lower radiation parameters. We established benchmark radiation parameters for retinoblastoma SOAC in our patient cohort.
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retinal reattachment and erg recovery after ophthalmic artery Chemosurgery for advanced retinoblastoma in eyes with minimal baseline retinal function
British Journal of Ophthalmology, 2017Co-Authors: Aliaa H Abdelhakim, Jasmine H Francis, Pierre Y Gobin, Brian P Marr, David H Abramson, Scott E BrodieAbstract:Aim To report retinal function outcomes after ophthalmic artery Chemosurgery (OAC) for advanced retinoblastoma (RB) in eyes with minimal pretreatment retinal function. Methods For 72 advanced RB eyes with baseline electroretinograms (ERGs) indistinguishable from noise (‘extinguished’) or flicker ERG amplitudes Results At 3 months, 1 year and 2 years post-OAC, ‘extinguished’ eyes showed 9/15, 4/11 and 2/6 detectable ERGs, respectively, and ‘poor’ eyes showed 19/55, 14/30 and 8/18 ERGs exceeding 25 μV, respectively. Correlations between baseline and post-OAC ERGs were poor; however, good correlation (R 2 ) existed between ERGs post-OAC at 3 months and 1 year (0.749), at 3 months and 2 years (0.773) and at 1 year and 2 years (0.771). Overall, 49/70 eyes presented with RD; 29 RDs resolved 3 months post-OAC, with an average ERG change of +20.6 μV. Eyes with persistent RD had an average ERG change of −2.2 μV. No eyes underwent ≥25 μV change without RD resolution. Conclusions Minimal baseline ERGs do not preclude significant recovery of retinal function after OAC. Good correlation exists between ERG outcomes at 3 months and those at subsequent follow-ups, suggesting that ERG amplitudes at 3-month post-OAC can prognosticate longer term retinal function, and that improvement is durable. For eyes presenting with RD, RD resolution is necessary but not sufficient for significant (≥25 μV) increases in ERG amplitudes.
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ophthalmic artery Chemosurgery for eyes with advanced retinoblastoma
Ophthalmic Genetics, 2017Co-Authors: David H Abramson, Jasmine H Francis, Ira J Dunkel, Brian P Marr, Scott E Brodie, Armida W M Fabius, Anna Escuder, Pierre Y GobinAbstract:ABSTRACTBackground: Surgical removal of one or both eyes has been the most common way to treat children with retinoblastoma worldwide for more than 100 years. Ophthalmic artery Chemosurgery (OAC) was introduced 10 years ago and it has been used as an alternative to enucleation for eyes with advanced retinoblastoma. The purpose of this report is to analyze our 9-year experience treating advanced retinoblastoma eyes with OAC.Materials and methods: Single-arm retrospective study from a single center of 226 eyes with eyes of retinoblastoma patients with advanced intraocular disease defined as both Reese-Ellsworth (RE) “Va” or ”Vb” and International Classification Retinoblastoma (ICRb) group “D” or ”E” (COG Classification). Ocular survival, patient survival, second cancers, and electroretinography (ERG) were assessed.Results: Ocular survival at five years for these advanced eyes was 70.2% (95% confidence interval, 57.3%–79.8%). When eyes were divided into groups either by RE classification or ICRb, no signific...
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simultaneous bilateral ophthalmic artery Chemosurgery for bilateral retinoblastoma tandem therapy
PLOS ONE, 2016Co-Authors: Jasmine H Francis, Ira J Dunkel, Brian P Marr, David H Abramson, Armida W M FabiusAbstract:Objective Report on the 7-year experience with bilateral ophthalmic artery Chemosurgery (OAC-Tandem therapy) for bilateral retinoblastoma. Design Retrospective, single institution study. Subjects 120 eyes of 60 children with bilateral retinoblastoma treated since March 2008. Methods Retrospective review of all children treated at Memorial Sloan Kettering with bilateral ophthalmic artery Chemosurgery (Melphalan, Carboplatin, Topotecan, Methotrexate) delivered in the same initial session to both naive and previously treated eyes. Main Outcome Measures Ocular survival, metastatic disease, patient survival from metastases, second cancers, systemic adverse effects, need for transfusion of blood products, electroretinogram before and after treatment. Results 116 eyes were salvaged (4 eyes were enucleated: 3 because of progressive disease, 1 family choice). Kaplan Meier ocular survival was 99.2% at one year, 96.9% at 2 and 3 years and 94.9% for years 4 through 7. There were no cases of metastatic disease or metastatic deaths with a mean follow-up of 3.01 years. Two children developed second cancers (both pineoblastoma) and one of them died. Transfusion of blood products was required in 3 cases (4 transfusions), 1.9%. Two children developed fever/neutropenia requiring hospitalization (0.95%). ERGs were improved in 21.6% and unchanged after treatment in 52.5% of cases (increase or decrease of less than 25μV). Conclusions Bilateral ophthalmic artery Chemosurgery is a safe and effective technique for managing bilateral retinoblastoma-even when eyes are advanced bilaterally, and if both eyes have progressed after systemic chemotherapy. Ocular survival was excellent (94.9% at 8 years), there were no cases of of metastatic disease and no deaths from metastatic disease, but children remain at risk for second cancers. In 21.6% of cases ERG function improved. Despite using chemotherapy in both eyes in the same session, systemic toxicity was low.
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intra arterial chemotherapy ophthalmic artery Chemosurgery for group d retinoblastoma
PLOS ONE, 2016Co-Authors: David H Abramson, Jasmine H Francis, Pierre Y Gobin, Ira J Dunkel, Brian P Marr, Scott E Brodie, Anthony B DanielsAbstract:Purpose To report globe salvage rates, patient survival and adverse events of ophthalmic artery Chemosurgery (OAC) for International Classification of Retinoblastoma (ICRB) group D retinoblastoma (naive and after prior failures).
Scott E Brodie - One of the best experts on this subject based on the ideXlab platform.
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association of electroretinography with visual outcomes after ophthalmic artery Chemosurgery for retinoblastoma in icrb d and e eyes
PLOS ONE, 2019Co-Authors: Jasmine H Francis, Pierre Y Gobin, Scott E Brodie, David H Abramson, Ariana M. Levin, Molly McfaddenAbstract:Importance Predictions of visual outcomes are useful in clinical and family decisions regarding treatment for retinoblastoma. Very little has been published on the association of post-treatment visual acuity with pre-treatment electroretinography (ERG), which can be performed on infants too young to reliably quantify visual acuity. Objective To report associations of pre-treatment ERG with post-treatment visual acuity in eyes with advanced retinoblastoma treated with ophthalmic artery Chemosurgery (OAC). Design Retrospective case-control study of eyes treated from 2006 through 2017, with mean follow-up of 51 months (range 2.3–150 months). Setting Single large academic center. Participants Group D and E eyes treated with OAC at Memorial Sloan Kettering Cancer Center with recorded visual acuity and ERG (30Hz flicker). Main outcome and measure Snellen visual acuity (uncorrected) compared to initial 30Hz flicker ERG. Results This study included 157 Group D and E eyes. Results of the Jonckheere-Terpstra test for trend were statistically significant and indicated that eyes with lower pre-treatment ERG readings tended to have more visual impairment post-treatment. Among eyes with initial ERG 75+ μV, 11 of 32 eyes (34%) had visual acuity 20/40 or better. Among eyes with ERG 0 μV, 44 of 46 (96%) had visual acuity of 20/200 or worse. Conclusions and relevance Eyes with advanced intraocular retinoblastoma treated with OAC can achieve excellent visual acuity, but poor ERG at initial visit is associated with poor visual acuity after treatment in the majority of eyes. Expectations regarding visual potential may influence decisions about treatment.
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total retinal detachments due to retinoblastoma outcomes following intra arterial chemotherapy ophthalmic artery Chemosurgery
PLOS ONE, 2018Co-Authors: Megan Rowlands, Jasmine H Francis, Pierre Y Gobin, Ira J Dunkel, Scott E Brodie, Ariana M. Levin, Ijah Mondesirecrump, Audrey Mauguen, David H AbramsonAbstract:PURPOSE To report on the rate and timing of retinal reattachment and outcomes for retinoblastoma children who have total retinal detachments at presentation to our center and were treated with intra-arterial chemotherapy (ophthalmic artery Chemosurgery, OAC). PATIENTS AND METHODS Single-center retrospective review of retinoblastoma patients who presented with total retinal detachments and were subsequently treated with OAC at MSKCC between May 2006 and July 2016. Endpoints were retinal detachment resolution, visual function, ERG amplitude, ocular survival, and patient survival from metastases. RESULTS 87 eyes of 84 retinoblastoma patients were included. Using a survival multistate model, by 36 months of follow-up, there was a 54% cumulative probability of complete retinal reattachment and a 76% probability of partial reattachment. 24% of eyes that completely reattached received only OAC without any prior or adjuvant treatments. Eyes that completely reattached were significantly more likely to have been diagnosed at a younger age (p<0.0001) and to have greater initial ERG values (p = 0.006). At final follow-up, 14% of eyes had gained at least 25 μV of ERG activity, and 8.0% had achieved hand motion vision or better, including one to 20/60. 13% of eyes were enucleated. No patient died from metastatic disease, and only one developed metastases. CONCLUSION OAC can successfully treat previously considered "non-salvageable" retinoblastoma eyes with total retinal detachments, promote retinal reattachment in the majority of eyes, and preserve ocular and patient survival.
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retinoblastoma vitreous seed clouds class 3 a comparison of treatment with ophthalmic artery Chemosurgery with or without intravitreous and periocular chemotherapy
Ophthalmology, 2017Co-Authors: Jasmine H Francis, Pierre Y Gobin, Scott E Brodie, David H Abramson, Saipriya IyerAbstract:Purpose To compare the efficacy and toxicity of treating class 3 retinoblastoma vitreous seeds with ophthalmic artery Chemosurgery (OAC) alone versus OAC with intravitreous chemotherapy. Design Retrospective cohort study. Participants Forty eyes containing clouds (class 3 vitreous seeds) of 40 retinoblastoma patients (19 treated with OAC alone and 21 treated with OAC plus intravitreous and periocular chemotherapy). Methods Ocular survival, disease-free survival and time to regression of seeds were estimated with Kaplan-Meier estimates. Ocular toxicity was evaluated by clinical findings and electroretinography: 30-Hz flicker responses were compared at baseline and last follow-up visit. Continuous variables were compared with Student t test, and categorical variables were compared with the Fisher exact test. Main Outcome Measures Ocular survival, disease-free survival, and time to regression of seeds. Results There were no disease- or treatment-related deaths and no patient demonstrated externalization of tumor or metastatic disease. There was no significant difference in the age, laterality, disease, or disease status (treatment naive vs. previously treated) between the 2 groups. The time to regression of seeds was significantly shorter for eyes treated with OAC plus intravitreous chemotherapy (5.7 months) compared with eyes treated with OAC alone (14.6 months; P P = 0.05). The 36-month Kaplan-Meier estimates of ocular survival were 83.3% (95% confidence interval, 56.7%–94.3%) for the OAC alone group and 100% for the OAC plus intravitreous chemotherapy group ( P = 0.16). The mean change in electroretinography responses was not significantly different between groups, decreasing by 11 μV for the OAC alone group and 22 μV for the OAC plus intravitreous chemotherapy group ( P = 0.4). Conclusions Treating vitreous seed clouds with OAC and intravitreous and periocular chemotherapy, compared with OAC alone, resulted in a shorter time to regression and was associated with fewer recurrences requiring additional treatment and fewer enucleations. The toxicity to the retina does not seem to be significantly worse in the OAC plus intravitreous chemotherapy group.
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retinal reattachment and erg recovery after ophthalmic artery Chemosurgery for advanced retinoblastoma in eyes with minimal baseline retinal function
British Journal of Ophthalmology, 2017Co-Authors: Aliaa H Abdelhakim, Jasmine H Francis, Pierre Y Gobin, Brian P Marr, David H Abramson, Scott E BrodieAbstract:Aim To report retinal function outcomes after ophthalmic artery Chemosurgery (OAC) for advanced retinoblastoma (RB) in eyes with minimal pretreatment retinal function. Methods For 72 advanced RB eyes with baseline electroretinograms (ERGs) indistinguishable from noise (‘extinguished’) or flicker ERG amplitudes Results At 3 months, 1 year and 2 years post-OAC, ‘extinguished’ eyes showed 9/15, 4/11 and 2/6 detectable ERGs, respectively, and ‘poor’ eyes showed 19/55, 14/30 and 8/18 ERGs exceeding 25 μV, respectively. Correlations between baseline and post-OAC ERGs were poor; however, good correlation (R 2 ) existed between ERGs post-OAC at 3 months and 1 year (0.749), at 3 months and 2 years (0.773) and at 1 year and 2 years (0.771). Overall, 49/70 eyes presented with RD; 29 RDs resolved 3 months post-OAC, with an average ERG change of +20.6 μV. Eyes with persistent RD had an average ERG change of −2.2 μV. No eyes underwent ≥25 μV change without RD resolution. Conclusions Minimal baseline ERGs do not preclude significant recovery of retinal function after OAC. Good correlation exists between ERG outcomes at 3 months and those at subsequent follow-ups, suggesting that ERG amplitudes at 3-month post-OAC can prognosticate longer term retinal function, and that improvement is durable. For eyes presenting with RD, RD resolution is necessary but not sufficient for significant (≥25 μV) increases in ERG amplitudes.
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ophthalmic artery Chemosurgery for eyes with advanced retinoblastoma
Ophthalmic Genetics, 2017Co-Authors: David H Abramson, Jasmine H Francis, Ira J Dunkel, Brian P Marr, Scott E Brodie, Armida W M Fabius, Anna Escuder, Pierre Y GobinAbstract:ABSTRACTBackground: Surgical removal of one or both eyes has been the most common way to treat children with retinoblastoma worldwide for more than 100 years. Ophthalmic artery Chemosurgery (OAC) was introduced 10 years ago and it has been used as an alternative to enucleation for eyes with advanced retinoblastoma. The purpose of this report is to analyze our 9-year experience treating advanced retinoblastoma eyes with OAC.Materials and methods: Single-arm retrospective study from a single center of 226 eyes with eyes of retinoblastoma patients with advanced intraocular disease defined as both Reese-Ellsworth (RE) “Va” or ”Vb” and International Classification Retinoblastoma (ICRb) group “D” or ”E” (COG Classification). Ocular survival, patient survival, second cancers, and electroretinography (ERG) were assessed.Results: Ocular survival at five years for these advanced eyes was 70.2% (95% confidence interval, 57.3%–79.8%). When eyes were divided into groups either by RE classification or ICRb, no signific...