Ophthalmology

Ophthalmic hospital named Jules Gonin


University Ophthalmology Service Serving Health Shelter
Foundation for Blind Eyes

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…………………………. Avenue de France 15

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  post office 5143 CH-1002 Lausanne ONKO center Pediatric Ophthalmic Oncology
  

Responsible Professor Francis Mounier
Tenured professor T +41 21 626 BS 8O
Fax [phone]
[e-mail] N / réf. MU / CS /


SR Lausanne, 5 March 2021
For parents [e-mail]

Child Erkinov Khusan 07.12.2019 г.р.
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Observation report


On March 5, 2021, we re-examined little Husan under general anesthesia Diagnosis: Bilateral hereditary retinoblastoma (father with retinoma OD) Genetic analysis: recommended Condition after three systematic courses of chemotherapy (first course: 31.10.2020, Etoposide, Carboplatin; second course: 30.11 to 07.12.2020, Etoposide, Carboplatin; third course: 03.01.2021,


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Etoposide, Carboplatin, Vincristine) (Uzbekistan) Condition after 1 intra-arterial injection OS (10.02.21) MRI (05.10.2020, 05.02.2021) Uzbekistan Operation: ESN As for the condition of the eyes to date, we have done the following studies:


Intraocular pressure:
O_OD_S:_:1₁9m_7mm._mrt._.s_Ht _g.st


Biomicroscopic examination: OD: transparent cornea. Iridocorneal synechiae from 7 to 11 o'clock. Vacuolar subcapsular cataract. Retinal fold with retro-crystalline attachment between the 4th and 10th meridians, causing tension on the lens. The inferior temporal equator is clearly visible after dilation. OS: transparent cornea, anterior chamber intact. Iridocorneal synechiae at 11 am and from 1:30 am to 5.
Attachment of the retina between the 6th and 9th meridians and in the supra-nasal direction. Absence of iris rubeosis. Initial cataract.
Fundus examination OD: The retina is still not visible due to dense intraocular hemorrhage, which is in the process of resorption. The jagged edge is difficult to assess, but does not appear to be violated.
OS: The optic nerve is not visible, covered with a large tumor that appears to be completely calcified, the epicenter of which is at the 7:30 meridian with a perilative retinal elevation. Examination of the peripheral retina with a depression shows calcifications in the lower part, as well as a retinal fold in the supra-nasal part and a second that attaches to the posterior crystalloid between the 6 o'clock and 9 o'clock meridians. The vertical-temporal retina is also superimposed in front of the equator. There is no other tumor


Child Erkinov Khusan 07.12.2019
.Fluorescence angiography (FAG): OD: no iris rubeose. The retinal vasculature cannot be assessed due to intraocular hemorrhage. OS: no neovascularization.


Conclusion: At the oncological level, we can consider that the first intra-arterial chemotherapy allowed to combine systematic chemotherapy and contribute to deep sterilization of the main focus, as well as the optic nerve head, without changing the discussed ophthalmic aspect of the focus. Since the left eye is still on probation, we scheduled an MRI of the brain for April 9, 2021. In this regard, we do not give an indication for a second intra-arterial injection of Merphalan. As for the fundus of the right eye, it is still masked by retro- hyaloid hemorrhage, which is currently in the process of resorption.
We plan to re-examine Husan for a new examination under general anesthesia in order to evaluate any new tumor or recurrence and give indications for their treatment in 5 weeks, that is, on April 12, 2021. This examination will be preceded by an orthoptic consultation, designed to better identify which eye to assign to the photosensitivity inherited from the parents.
Dr. F Mounier, Professor


Ordinary Chap. doctor (signature) Copy: Maya Bek Popovich,


Oncopediatrics, UGTsV. 1011 Lausanne