Treatment of Unilateral Retinoblastoma — ICRB Group A or Group B with Macular Sparing
This protocol addresses unilateral retinoblastoma classified as ICRB Group A or ICRB Group B with macular sparing — small tumors presenting without high-risk features such as extraocular extension, choroidal invasion, or optic nerve invasion.
Clinical Scenario
Small unilateral retinoblastoma (ICRB Group A or Group B with macular sparing) without evidence of extraocular extension or high-risk pathological features. This low-risk presentation allows a targeted, eye-preserving approach focused on direct tumor consolidation.
Treatment Approach
Management centres on focal therapy for tumor consolidation. The approach involves established local ablative techniques applied under indirect ophthalmoscopy — with multiple treatment sessions typically required over several weeks.
Full regimen details, session parameters, and sequencing available via the link below →
Treatment Goal
Flat scar or completely calcified tumor, with confirmed regression of the treated lesion.
References
DOI: 10.4103/ijo.IJO_721_20
- TTT is usually administered through indirect ophthalmoscopy, using a 810 nm diode laser on continuous mode.
- A triple-freeze-thaw technique is preferably employed, visualizing the tumor becoming entirely encased in an ice ball and then waiting for a complete thaw prior to applying the following freeze cycle.
- Multiple TTT sessions, ranging from 2-6, are usually required at 4 week intervals, to achieve the endpoint of a flat scar or completely calcified tumor.
- As with cryotherapy, TTT can be used in combination with chemotherapy as primary treatment for small tumors less than 3 mm in diameter and 2 mm in thickness.
- Indications include treatment of small tumors and foci of sub retinal or preretinal seeds.
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