How We Diagnose Retinoblastoma
Retinoblastoma is a cancerous tumor that grows in the retina, the light-sensing part of the eye. It’s not usually noticeable at birth. Most children are diagnosed during the first 24 months of life. Retinoblastoma is a highly treatable cancer. It's estimated that more than 90% of children in the U.S. diagnosed with retinoblastoma can be cured.
From your first visit with us, you'll work with a dedicated team that’s committed to giving your child the very best care and giving your family the support you need. We begin by doing a careful diagnosis using a physical exam and other tests to determine the best course of treatment for your child. We use advanced imaging exams such as optical coherence tomography (OCT). In this test, a handheld device gives us a clear picture of your child's retina in seconds. We use imaging (like MRI), blood tests, or samples (biopsies) of bone marrow or spinal fluid, if needed, to see if cancer is anywhere else in your child’s body.
Retinoblastoma can be caused by a genetic mutation, so a blood test also tells us whether your child has hereditary retinoblastoma. Because children with this form of the disease are at risk for other tumors, long-term regular checkups are recommended. In addition, if your child has the genetic mutation, other members of the family should have blood tests to check for the gene. Our genetic counselors will discuss your family’s risk, who should be tested, and what steps should be taken to evaluate for cancer.
Treatments for Retinoblastoma
Your child’s care team will discuss which options offer your child the best results and what you can expect during treatment and recovery. In most instances, treatment is done on an outpatient basis. All treatments are done while your child is asleep under general anesthesia, which is administered by specialized pediatric anesthesiologists. We use the least-invasive methods to treat retinoblastoma. Radiation and surgery are used only when other treatments aren’t possible.
Intra-Venous (Systemic) Chemotherapy
This therapy is administered by the pediatric oncology team. Most often, it requires six cycles of treatment (once a month). A specialized pediatric oncologist will provide a detailed explanation about how it works and the risks and benefits.
This targeted therapy delivers cancer-fighting medicine directly into the ophthalmic artery, the eye’s main blood vessel. A pediatric neurosurgeon delivers the chemotherapy to the ophthalmic artery using a thin, flexible tube called a catheter that is inserted in your child's upper leg.
Intravitreal Chemotherapy (IVT)
IVT is another type of targeted chemotherapy. It treats tumors that develop within the vitreous, the jelly-like substance inside the eye. In this procedure, an ocular oncologist injects medicine directly into the vitreous humor to destroy cancer cells.
Cold therapy, also called cryotherapy, uses a small metal probe to kill cancer cells by freezing them. During the procedure, the doctor places a very cold probe against the outer surface of the eyeball next to the tumor. The area is frozen and thawed several times to destroy cancer cells.
Thermotherapy (transpupillary thermotherapy, or TTT) uses an infrared-light laser to destroy cancer cells. There is less damage to surrounding blood vessels because the temperature of the laser isn't as high as with other types of laser therapy.