nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.21682/2311-1267-2022-9-3-65-74nodgo-859Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSОсложнения локального лечения ретинобластомы и их лечение (обзор литературы)Complications of local treatment of retinoblastoma and their treatment (literature review)https://orcid.org/0000-0002-0072-8275ЧочаеваА. М.ChochaevaA. M.

Амина Мухаматовна Чочаева, врач-аспирант.

SPIN-код: 1637-9792

127486, Москва, Бескудниковский бул., 59а

Ophthalmologist, Postgraduate Student. SPIN-code: 1637-9792

59a Beskudnikovsky Blvd., Moscow, 127486

chochaevaamina@mail.ruhttps://orcid.org/0000-0002-3660-7803ВолодинД. П.VolodinD. P.

врач-аспирант.

SPIN-код: 7404-9620

127486, Москва, Бескудниковский бул., 59а

Ophthalmologist, Postgraduate Student. SPIN-code: 7404-9620

59a Beskudnikovsky Blvd., Moscow, 127486

volodin.den2016@yandex.ruhttps://orcid.org/0000-0002-3396-5461КотоваЕ. С.KotovaE. S.

врач-аспирант.

SPIN-код: 9605-2491

127486, Москва, Бескудниковский бул., 59а

Ophthalmologist, Postgraduate Student. SPIN-code: 9605-2491

59a Beskudnikovsky Blvd., Moscow, 127486

elenkotenko@gmail.comhttps://orcid.org/0000-0003-2219-7054ЯровойА. А.YarovoyA. A.

д.м.н., заведующий отделом офтальмоонкологии и радиологии.

SPIN-код: 9401-4489

127486, Москва, Бескудниковский бул., 59а

Dr. of Sci. (Med.), Head of Ocular Oncology and Radiology Department. SPIN-code: 9401-4489

59a Beskudnikovsky Blvd., Moscow, 127486

yarovoyaa@yandex.ruФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава РоссииРоссияNational Medical Research Center Academician S.N. Fyodorov Intersectoral Scientific and Technical Complex “Eye microsurgery”, Ministry of Health of RussiaRussian Federation202209112022936574Copyright © Чочаева А.М., Володин Д.П., Котова Е.С., Яровой А.А., 20222022Чочаева А.М., Володин Д.П., Котова Е.С., Яровой А.А.Chochaeva A.M., Volodin D.P., Kotova E.S., Yarovoy A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/859

Благодаря методам лечения, которые существуют на сегодняшний день, выживаемость пациентов с ретинобластомой (РБ) достигла 100 %. Несмотря на положительные результаты лечения РБ, в ряде случаев отмечаются внутриглазные осложнения. Осложнения, затрудняющие визуализацию глазного дна, препятствуют контролю опухолевой ткани в динамике, что является показанием к энуклеации глазного яблока. Несмотря на современные успехи в развитии интраокулярной хирургии и положительный опыт ее применения, важным аспектом является тот факт, что любые интраокулярные вмешательства сопряжены с высоким риском диссеминации опухоли, что требует тщательной оценки состояния опухоли в динамике и уверенности в стабильности ремиссии, что не всегда возможно при непрозрачных оптических средах. В связи с этим возникает вопрос о консервативных методах лечения стойких осложнений.

Учитывая маленький возраст пациентов, сложно выполнять консервативное лечение в полном объеме. Эффективными являются ретробульбарные инъекции, которые максимально близко доставляют лекарственный препарат к заднему полюсу глаза. Однако для максимальной концентрации препарата необходимо частое выполнение инъекций, что является достаточно травматичным, сопровождается болевым синдромом и способствует рубцеванию ретробульбарной клетчатки. Одним из способов, который помогает избежать указанных нежелательных явлений, является ретробульбарная инфузионная терапия.

В результате ретробульбарной инфузионной терапии в ретробульбарное пространство на несколько дней устанавливается силиконовая трубка (катетер) с последующим введением лекарственных препаратов несколько раз в день.

Обзор содержит данные о внутриглазных осложнениях после локального лечения РБ, а также о возможных методах их купирования.

Thanks to the treatments that are happening today, the survival rate of patients with retinoblastoma (Rb) has reached 100 %. Despite the positive results of Rb treatment, intraocular complications are observed in observations. Complications that cause visualization of the fundus impede the control of tumor tissue in dynamics, which is associated with enucleation of the eyeball. Despite modern advances in the use of intraocular surgery, a positive and important aspect is the fact that any experience of intraocular infections with a high risk of growth dissemination, which requires an accurate assessment of the state of growth in dynamics and confidence in the stability of remission, which is not always possible with opaque optical environments. In this regard, the question arises of conservative methods of treatment of persistent complications.

Given the small age of patients, this makes it difficult to perform conservative treatment in full. Effective are retrobulbar injections, which deliver the drug as close as possible to the posterior pole of the eye. However, for the maximum concentration of the drug, frequent injections are necessary, which is quite traumatic, accompanied by pain, and their frequent implementation contributes to scarring of the retrobulbar tissue. One way to avoid these adverse events is retrobulbar infusion therapy.

As a result of retrobulbar infusion therapy, a silicone tube (catheter) is placed in the retrobulbar space for several days, followed by the administration of drugs several times a day.

The review contains data on intraocular complications after local treatment of Rb, as well as possible methods for their relief.

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The authors declare that there are no conflicts of interest present.