Monthly Archives: July 2021

Case #58 – Neurofibromatosis Type 1 – Page 4 of 11

Patient #2 Heidelberg Spectralis® IR of the right and left eyes (top black and white images) with corresponding Optos California® fundus images (bottom color images)

Case #58 – Neurofibromatosis Type 1 – Page 4 of 112023-01-31T21:28:35+00:00

Case #58 – Neurofibromatosis Type 1 – Page 3 of 11

Case Report: Patient #3 (62 yo F) BCVA 20/20 OD/OS (+) Lisch nodules OU Heidelberg Spectralis® EDI-OCT of the right (top) and left (bottom) eyes Reports in the literature describe hyper-reflectant lesions seen with infra-red (IR) imaging, in patients with NF1. Below are the hyper-reflectant lesions marked

Case #58 – Neurofibromatosis Type 1 – Page 3 of 112023-01-31T21:28:35+00:00

Case #58 – Neurofibromatosis Type 1 – Page 2 of 11

Case Report: Patient #2 (47 yo F): BCVA 20/20 OD/OS (+) Lisch nodules OU optic nerve glioma OD Heidelberg Spectralis® EDI-OCT of the right (top) and left (bottom) eyes

Case #58 – Neurofibromatosis Type 1 – Page 2 of 112023-01-31T21:28:35+00:00

Case #58 – Neurofibromatosis Type 1 – Page 1 of 11

Examples of Lisch nodules of the iris (top image) and Optos California® fundus images (bottom two images) of optic nerve atrophy OU secondary to optic nerve glioma in Patient #1 Various reports1-7 have highlighted a potential new clinical feature of NF1. Here we present two patients with this clinical

Case #58 – Neurofibromatosis Type 1 – Page 1 of 112023-01-31T21:28:35+00:00

Case #58 – Neurofibromatosis Type 1 – Page 0 of 11

NF1, CAN YOU “SPOT” THE CLINICAL FEATURE?   Introduction: Neurofibromatosis Type 1 (NF1) is a genetic condition which there is dysfunction of the neurofibromin protein which plays a role in tumor suppression and therefore causes multiple tumors of neural crest origin.1Two or more of the following characteristics are needed to diagnose NF1: six or

Case #58 – Neurofibromatosis Type 1 – Page 0 of 112023-01-31T21:28:36+00:00

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 6 of 9

ReferencesManjandavida FP, Shields CL. The role of intravitreal chemotherapy for retinoblastoma. Indian J Ophthalmol. 2015;63(2):141-145.Abramson DH, Ji X, Francis JH, Catalanotti F, Brodie SE, Habib L. Intravitreal chemotherapy in retinoblastoma: expanded use beyond intravitreal seeds. Br J Ophthalmol. 2019;103(4):488-493.Raval V, Bowen C, Soto H, Singh A. Chemotherapy for Retinoblastoma: Impact of Intravitreal Chemotherapy. Asia Pac

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 6 of 92023-01-31T21:28:36+00:00

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 5 of 9

OAC was introduced more than 10 years ago and has been shown to be effective in treating retinoblastoma.5 The majority of recurrences happen within the first year following the completion of OAC and eyes that receive drug via non-ophthalmic artery routes are more likely to recur.5 In this case, we inherited this patient after completing

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 5 of 92023-01-31T21:28:36+00:00

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 4 of 9

The right eye with completely regressed tumors at 3, 6 o’clock and adjacent to the optic nerve with remaining chorioretinal scarring, after 3 rounds of IVitC + laser. Intravenous chemotherapy (IVC) often includes the standard 3-drug regimen of vincristine, etoposide and carboplatin. When initially introduced, the main goal of IVC was to decrease

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 4 of 92023-01-31T21:28:36+00:00

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 3 of 9

What we did next: C. Intravitreal chemotherapy + laser Discussion:Intravitreal chemotherapy (IVitC) offers a localized treatment approach for recurrent intraocular tumors that is refractory to OAC. Traditionally, IVitC has been used to treat intravitreal seeds1 however recent use of IVitC for indications other than vitreous seeds has shown to be successful.2  IVitC avoids the time

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 3 of 92023-01-31T21:28:37+00:00

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 2 of 9

A magnified image of the tumor adjacent to the optic nerve at follow-up #3 What treatment intervention would be best going forward? A. Intravenous chemotherapy B. Ophthalmic artery chemosurgery C. Intravitreal chemotherapy + laser D. Enucleation

Case #59 – Retinoblastoma-Intravitreal Chemotherapy+Laser – Page 2 of 92023-01-31T21:28:37+00:00