{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:25:49Z","timestamp":1787772349806,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>\n                    The aim of this study was to retrospectively determine clinical features, treatment outcomes, and overall survival in four patients with metastatic retinoblastoma at presentation. The mean age at diagnosis was 63 months (range: 24\u2013108 months). Three patients had overt orbital disease of at least one eye and one patient had microscopic orbital disease with scleral infiltration on histopathology. Metastatic sites included regional lymph nodes (RLN) (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 4), bone marrow (BM) (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 2), and cerebrospinal fluid (CSF) (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 1). The most common sites of RLN were ipsilateral preauricular nodes (two patients) and contralateral parotid gland involvement (one patient). The treatment administered included primary enucleation (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 1), high-dose intravenous chemotherapy (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 4), secondary enucleation (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 2), orbital external beam radiotherapy (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 3), and intrathecal chemotherapy (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 1). High-risk features included massive choroidal and microscopic scleral infiltration in the eye that underwent primary enucleation. At a mean follow-up of 33 months (range, 4\u201368 months), one patient with CSF involvement deceased in 4 months. The remaining three patients were alive and disease-free at the last mean follow-up period of 43 months (range, 18\u201368 months). The results of our study showed that RLN and BM metastasis respond well to treatment while CSF metastasis is associated with poor prognosis.\n                  <\/jats:p>","DOI":"10.4103\/ojo.ojo_176_22","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T13:54:21Z","timestamp":1716558861000},"page":"524-528","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Metastatic retinoblastoma at presentation: Clinical presentation, treatment, and outcomes"],"prefix":"10.4103","volume":"16","author":[{"given":"Chandra L.","family":"Kakarala","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal Rameshkumar","family":"Raval","sequence":"additional","affiliation":[{"name":"The Operation Eyesight Universal Institute 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