Clinical Study
Eye (2006) 20, 466–470. doi:10.1038/sj.eye.6701912; published online 13 May 2005
Neuroblastoma with orbital metastasis: ophthalmic presentation and role of ophthalmologists
The authors have no financial or proprietary interests. This paper received no financial support from public/private bodies.
S Ahmed1, S Goel1, M Khandwala1, A Agrawal1, B Chang1 and I G Simmons1
1Ophthalmology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Correspondence: S Ahmed, Leeds Teaching Hospitals NHS Trust, Department of Ophthalmology, Chancellor Wing, Beckett Street, Leeds LS9 7TF, UK. Tel: +44 1132064737; Fax: +44 1132064268; E-mail: suheb@nhs.net
Received 1 November 2004; Accepted 17 March 2005; Published online 13 May 2005.
Abstract
Introduction
Neuroblastoma is predominantly a tumour of early childhood, which metastasises to the orbits. In such cases, ophthalmologists are involved in the multidisciplinary management. This unique series from a tertiary referral centre is used to elaborate the ophthalmic associations and the ophthalmologist's role in this rare condition.
Methods
A review of case notes was performed on six patients who presented to the paediatric ophthalmology – oncology liaison service at the Leeds teaching hospitals between 1998 and 2003. The ophthalmic outcome and role of the ophthalmologist were assessed.
Results
Average age of presentation was 29.8 months (range 15–69 months). Average duration of follow-up was 19.5 months (range 2–58 months). One child died during treatment. Two have completed treatment and are under follow-up. Presenting features of the six children were proptosis in four, periorbital ecchymosis in two, ocular motility restriction in two, and subconjunctival haemorrhage in one. Only one case developed blindness.
Conclusions
The role of the ophthalmologist in patients with metastatic orbital neuroblastoma can vary from a supportive role to one of active intervention and management of ophthalmic complications. The ophthalmologist is involved in diagnosis and staging as well as monitoring response to treatment of both the primary disease and secondary ophthalmic complications.
Keywords:
orbital, neuroblastoma, ophthalmology, metastasis
