Retinoblastoma

The article was written by Dr. BS Phung Tuyet Lan - Head of Pediatric Inpatient Unit 3, Pediatric Center - Vinmec Times City International Hospital

Retinoblastoma (NBVM) is the most common type of intraocular malignancy in children, originating in the cells of the retina (retina), which receive light that helps the eye to see objects. object.

The disease mainly occurs in young children in which 95% of children are under 5 years old. Incidence has been reported from 1/15,000 to 1/18,000 newborns. In the North of Vietnam every year about 40-50 children are diagnosed with retinoblastoma. If not detected and treated promptly, the tumor will grow very quickly, not only causing the patient to lose vision, but also can metastasize to many places in the body such as the central nervous system, bone marrow, and bone, causing serious health problems. life-threatening.
The disease may present in one eye (60%) or both eyes (40%), may be hereditary or non-hereditary, familial or individual. The cause of the disease is a mutation in the RB1 gene located on the long arm of chromosome 13.
The most typical and common clinical sign leading to parents taking their children to the doctor is "white pupil light" or "cat's eye", that is, a white spot in the middle of the pupil (the black center of the eye). . Initially, white pupil light is infrequent and may only be noticed from a few angles or under certain lighting conditions, for example when taking pictures with a flash.

Other signs may be encountered such as strabismus or crossed eyes, vision loss that makes it easy for children to stumble and walk, difficult to get objects, in addition, there are some other less common symptoms such as red, swollen eyes, protruding eyes, external eyes (delayed detection). Diagnosis of the disease is based on ophthalmoscopy (under anesthesia if the child does not cooperate), eye ultrasound, orbital-cranial magnetic resonance imaging, genetic testing for mutations and genetic counseling.

Treatment for retinoblastoma depends on the size, location of the tumor, and the number of affected eyes. When the tumor in the eye is large, it is necessary to remove the eyeball to save the child's life, then put a prosthetic eye.

Depending on the specific case, there will be indications for chemotherapy or radiation therapy. If the tumor is small, it can be treated conservatively to keep the eyeball and vision for the child, depending on the location and size of the tumor, it is possible to combine treatment methods such as laser, freezing, thermodynamics (laser combination). combination with chemicals), intraocular chemotherapy, ophthalmic arterial chemotherapy.
The late stage patients need to be actively treated with a combination of chemotherapy with surgery and radiotherapy, in metastatic cases need myelosuppressive chemotherapy combined with hematopoietic stem cell transplantation. In developed countries, the treatment results for retinoblastoma are very positive: over 95% of patients are cured and the rate of eyeball-vision preservation reaches 70%.
Retinoblastoma detected early has very high treatment results. Therefore, cases of children with suspicious symptoms such as white pupils, squinting/strabismus, poor vision, red eyes should be taken to an ophthalmology clinic soon, where there is experience in examining the fundus. Families with a history of retinoblastoma (parents or siblings with the disease) need genetic testing, prenatal counseling, and newborn babies need to be examined soon at specialized facilities. eyes to detect disease as early as possible.

Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology, but also stands out for its examination and consultation services. comprehensive and professional medical consultation and treatment; civilized, polite, safe and sterile medical examination and treatment space.
Customers can directly go to Vinmec Health system nationwide to visit or contact the hotline here for support.

SEE ALSO:
REGENERATION OF "SOUL WINDOWS" FOR "CAT-EYED BOY" Retinoblastoma: Causes, symptoms, diagnosis and treatment Successful treatment of retinoblastoma for boys 2 age according to Curie
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