Complications

Complication
Timeframe
Likelihood
short term
medium

Ophthalmic artery chemosurgery (also known as intra-arterial chemotherapy) has been associated with intraretinal hemorrhage and vascular occlusions.[107]

Diagnosis is based on clinical exam.

There is currently no treatment available. In some cases, enucleation should be considered if tumor response is compromised.

short term
medium

External beam radiation can cause cataract formation, as well as periorbital redness, edema, and dry eyes.

Diagnosis is based on the presence of decreased vision and slit lamp examination.

Removed via surgery after a sufficient period of tumor quiescence.

long term
high

Likelihood increases in children receiving radiation therapy before 6 months of age.

Diagnosis is based on clinical exam.

There is currently no treatment available.

variable
high

Periocular carboplatin therapy has the potential for major ocular adverse effects such as fibrosis of the extraocular muscles and optic nerve atrophy.[82][83] There is no systemic toxicity.

Diagnosis is based on clinical exam.

There is currently no treatment available.

variable
medium

Periocular carboplatin therapy can cause optic nerve atrophy in some cases.[82][83]

Diagnosis is based on the presence of decreased vision, presence of a relative afferent pupillary defect, and pallor of the optic nerve.

There is currently no treatment available.

variable
low

Chemotherapy and radiation therapy for retinoblastoma has the potential to induce secondary malignancies (e.g., lymphoma, leukemia). The epipodophyllotoxin etoposide is known to induce secondary leukemias characterized by site-specific DNA rearrangements in pediatric cancer patients.[108]

Typically diagnosed clinically based on symptoms arising from the affected area (e.g., bony pain in the case of an osteogenic sarcoma).

Managed by pediatric oncologists and general surgeons in the same manner as primary malignancies of the same subtype, generally with combinations of surgery, chemotherapy, and radiation.

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