Electroretinogram monitoring of dose-dependent toxicity after ophthalmic artery chemosurgery in retinoblastoma eyes: Six year review Journal Article


Authors: Francis, J. H.; Abramson, D. H.; Gobin, Y. P.; Marr, B. P.; Dunkel, I. J.; Riedel, E. R.; Brodie, S. E.
Article Title: Electroretinogram monitoring of dose-dependent toxicity after ophthalmic artery chemosurgery in retinoblastoma eyes: Six year review
Abstract: Purpose: To report electroretinogram responses of retinoblastoma children under anesthesia before and after treatment with chemotherapeutic drugs (melphalan, topotecan, carboplatin) delivery by ophthalmic artery chemosurgery (OAC).Methods: A cohort study of 81 patients with retinoblastoma treated with OAC. All patients treated with OAC at our center through May 2012 for whom the requisite ERG data were available are included in the analysis. This study recorded the ERG 30 Hz flicker amplitude response changes from baseline, at 3 and 12 months following OAC treatment completion. Both univariate and multivariate linear regression models were evaluated, with generalized estimating equations to correct for correlations within patients. Independent numerical variables included maximum doses and cumulative doses of melphalan, topotecan and carboplatin.Results: By univariate analysis, both melphalan and topotecan appear to be associated with changes in ERG amplitude at both 3 and 12 months; but for the most part, these changes are minimal and likely clinically insignificant. By multivariate analysis, maximum and cumulative melphalan have a modest, temporary effect on the ERG amplitude change, which is apparent at 3 months but no longer evident at 12 months after completing treatment. By multivariate analysis, topotecan and carboplatin do not appear to adversely effect the change in ERG response.Conclusion: Melphalan has the strongest, and carboplatin the weakest association with reduction in ERG response amplitudes; but for the most part, these changes are minimal and likely clinically insignificant. These conclusions apply only over the dose ranges used here, and should be applied with caution.
Keywords: electroretinogram
Journal Title: PLoS ONE
Volume: 9
Issue: 1
ISSN: 1932-6203
Publisher: Public Library of Science  
Date Published: 2014-01-20
Start Page: e84247
Language: English
ACCESSION: BCI:BCI201400198204
DOI: 10.1371/journal.pone.0084247
PROVIDER: biosis
PMCID: PMC3896342
PUBMED: 24465398
Notes: Article -- 38 -- Source: Biosis
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MSK Authors
  1. Brian Marr
    112 Marr
  2. Ira J Dunkel
    371 Dunkel
  3. Jasmine Helen Francis
    256 Francis
  4. David H Abramson
    389 Abramson
  5. Scott Brodie
    38 Brodie