A 26 month old male presented to our clinic with a history of bilateral retinoblastoma, diagnosed 5 months prior.

  • Medical History: Negative. MRI of brain/orbits was performed without extraocular extension or brain metastasis.
  • Past Treatment history at outside institution:
    • 4 rounds of systemic chemotherapy with vincristine, etoposide and carboplatin
    • 1 round of ophthalmic artery chemosurgery (OAC) with 4mg melphalan and 1mg topotecan OD (followed by a second, unsuccessful attempt of OAC)
    • 1 round of cryotherapy OD
  • Baseline ocular examination with us:
    • Electroretinogram (ERG) measured with 30Hz flicker was obtained under anesthesia and measured to be 57mV OD and 77mV OS
    • Anterior segment was unremarkable without evidence of tumor seeding.
    • Intraocular pressures were 18mmHg and 14mmHg.
    • Fundus examination revealed a well-treated peripheral tumor with remaining chorioretinal scar OS. In the right eye, there were 3 recurrent retinal tumors at 3, 6 o’clock and adjacent to the optic nerve (see photo below)

The right eye with 3 recurrent tumors (at 3, 6 o’clock and adjacent to optic nerve) surrounded by chorioretinal scarring at presentation.