QuestionSBA
QuestionChoice
Chemotherapy can be considered in bilateral retinoblastoma or small tumours, however as this patient has advanced disease, enucleation is the best option.
10035433
b
Systemic chemotherapy
QuestionChoice
Anti-VEGF therapy is usually used in patients with vaso-proliferative retinopathies, e.g. diabetic retinopathy. It is not indicated in retinoblastoma.
10035435
d
Intravitreal anti-vascular endothelial growth factor therapy
QuestionChoice
Radiotherapy may be used to treat small tumours, or when the disease is bilateral, the most involved eye is enucleated and the less involved eye is irradiated. There are no indications for bilateral irradiation in this case. Enucleation of the left eye is the most appropriate choice.
10035436
e
Bilateral irradiation of the eyes
QuestionChoice
Removal of the eye (and as little of the optic nerve as possible) and insertion of a prosthesis is recommended in cases of retinoblastoma that is confined to the eye.
10035432
a
Enucleation
QuestionChoice
Laser photocoagulation may be used to manage small tumours, however as this patient has advanced disease, the eye should be removed to prevent metastases and resect the diseased areas.
10035434
c
Photocoagulation
Concept
Chapter
2693
6130
Retinoblastoma
Topic
140
Ophthalmology
19490
Enucleation is a surgical procedure in which the entire eyeball is removed to treat conditions like advanced retinoblastoma confined to the eye, aiming to prevent metastasis and preserve surrounding structures.
An 18-month-old girl is referred to the paediatric ophthalmology clinic after her GP noticed leukocoria in her left eye.

Ophthalmoscopy under general anaesthesia and an MRI confirm a likely diagnosis of advanced retinoblastoma, confined to the eye.

What is the most likely next step in management?
a