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INVASION OF THE OPTIC NERVE BY RETINOBLASTOMA

INVASION OF THE OPTIC NERVE BY RETINOBLASTOMA Abstract IN 19311 I published the results of a microscopic study of the incidence of invasion of the optic nerve by retinoblastoma. The report was based on a series of 119 enucleated eyes containing retinoblastoma. In 53 per cent of the eyes the tumor had extended into the optic nerve beyond the lamina cribrosa. In 43 per cent of the eyes the optic nerve was not severed at operation beyond the tumor extension, and, therefore, residual tumor had been left in that portion of the nerve remaining in the orbit. Thus, in 43 per cent of the cases a recurrence in the orbit and fatal termination were to be expected unless measures were directed against the residual tumor left in the nerve at the time of operation. The globes from which these statistics were gleaned were enucleated between the years 1878 and 1929, a period of fifty-one years. For some References 1. Reese, A. B.: Extension of Glioma (Retinoblastoma) into the Optic Nerve , Arch. Ophth. 5:269-271 ( (Feb.) ) 1931.Crossref 2. Hirschberg, J.: Anatomisch Untersuchungen über Glioma retinae , Arch. f. Ophth. 14 ( (pt. 2) ):30-102, 1868. 3. Wintersteiner, H.: Das Neuroepithelioma retinae , Vienna, Franz Deuticke, 1897. 4. Army Institute of Pathology: Personal communication to the author. 5. (a) Ray, B. S., and McLean, J. M.: Combined Intracranial and Orbital Operation for Retinoblastoma , Arch. Ophth. 30:437-445 ( (Oct.) ) 1943.Crossref 6. (b) Jean, G. W.: Discussion of Glioma of the Retina , Arch. Ophth. 51:505 ( (Sept.) ) 1922. 7. (c) Glioma of the Optic Nerve: Correspondence , J. A. M. A. 100:1793 ( (June 3) ) 1933. 8. (d) Dott, N. M., and Meighan, S.: Intracranial Resection of the Optic Nerve in Glioma Retinae , Am. J. Ophth. 16:59, 1933. 9. (e) Rand, C. W.: Glioma of Retina: Report of a Case with Intracranial Extension , Arch. Ophth. 11:982-994 ( (June) ) 1934.Crossref 10. (f) Shannon, C. E. G.; Jaeger, R., and Forster, F. M.: The Combined Intracranial and Orbital Operation for Bilateral Retinoblastoma , Tr. Am. Ophth. Soc. 42:326-333, 1944. 11. The accepted procedure in the combined intracranial and orbital operation for retinoblastoma is first to perform the cranial operation by excising the intracranial portion of the nerve between the chiasm and the optic foramen. The best worked-out technic has been published by Ray and McLean,5a and this includes coagulation of the optic nerve at the optic foramen and the insertion of a plug of muscle tissue over this site. Twelve to thirteen days later the enucleation is done, at which time the entire orbital portion of the nerve is removed, along with the globe. 12. Leber, T.: Die Geschwulstbildungen der Netzhaut , in Graefe, A., and Saemisch, T.: Handbuch der gesammten Augenheilkunde , Leipzig, Wilhelm Engelmann, 1916, vol. 7, pp. 1723-1943. 13. Adam, C.: Statistisches, Klinisches und Anatomisches über das Glioma retinae , Ztschr. f. Augenh. 25:330-350, 1911. 14. Merriam, G. R.: Retinoblastoma: An Autopsy Analysis of 15 Cases, to be published. 15. Almost any length of nerve may be secured at operation if the following procedure is practiced: Pass a heavy silk traction suture through the insertion stumps of the internal and external rectus muscles, engaging some of the adjacent sclera. When the optic nerve is cut, pull the globe forcibly outward with the traction sutures, placing the optic nerve on a stretch, and at the same time press the blades of the scissors backward along the nasal wall of the orbit. 16. The optic nerve should be severed from the globe flush with the sclera immediately after the enucleation. Sections for microscopic study should be cut from the proximal, distal and central portions of the nerve to determine whether there has been tumor extension and, if so, whether or not the operative section has been made beyond it. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

INVASION OF THE OPTIC NERVE BY RETINOBLASTOMA

Archives of Ophthalmology , Volume 40 (5) – Nov 1, 1948

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Publisher
American Medical Association
Copyright
Copyright © 1948 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1948.00900030566007
Publisher site
See Article on Publisher Site

Abstract

Abstract IN 19311 I published the results of a microscopic study of the incidence of invasion of the optic nerve by retinoblastoma. The report was based on a series of 119 enucleated eyes containing retinoblastoma. In 53 per cent of the eyes the tumor had extended into the optic nerve beyond the lamina cribrosa. In 43 per cent of the eyes the optic nerve was not severed at operation beyond the tumor extension, and, therefore, residual tumor had been left in that portion of the nerve remaining in the orbit. Thus, in 43 per cent of the cases a recurrence in the orbit and fatal termination were to be expected unless measures were directed against the residual tumor left in the nerve at the time of operation. The globes from which these statistics were gleaned were enucleated between the years 1878 and 1929, a period of fifty-one years. For some References 1. Reese, A. B.: Extension of Glioma (Retinoblastoma) into the Optic Nerve , Arch. Ophth. 5:269-271 ( (Feb.) ) 1931.Crossref 2. Hirschberg, J.: Anatomisch Untersuchungen über Glioma retinae , Arch. f. Ophth. 14 ( (pt. 2) ):30-102, 1868. 3. Wintersteiner, H.: Das Neuroepithelioma retinae , Vienna, Franz Deuticke, 1897. 4. Army Institute of Pathology: Personal communication to the author. 5. (a) Ray, B. S., and McLean, J. M.: Combined Intracranial and Orbital Operation for Retinoblastoma , Arch. Ophth. 30:437-445 ( (Oct.) ) 1943.Crossref 6. (b) Jean, G. W.: Discussion of Glioma of the Retina , Arch. Ophth. 51:505 ( (Sept.) ) 1922. 7. (c) Glioma of the Optic Nerve: Correspondence , J. A. M. A. 100:1793 ( (June 3) ) 1933. 8. (d) Dott, N. M., and Meighan, S.: Intracranial Resection of the Optic Nerve in Glioma Retinae , Am. J. Ophth. 16:59, 1933. 9. (e) Rand, C. W.: Glioma of Retina: Report of a Case with Intracranial Extension , Arch. Ophth. 11:982-994 ( (June) ) 1934.Crossref 10. (f) Shannon, C. E. G.; Jaeger, R., and Forster, F. M.: The Combined Intracranial and Orbital Operation for Bilateral Retinoblastoma , Tr. Am. Ophth. Soc. 42:326-333, 1944. 11. The accepted procedure in the combined intracranial and orbital operation for retinoblastoma is first to perform the cranial operation by excising the intracranial portion of the nerve between the chiasm and the optic foramen. The best worked-out technic has been published by Ray and McLean,5a and this includes coagulation of the optic nerve at the optic foramen and the insertion of a plug of muscle tissue over this site. Twelve to thirteen days later the enucleation is done, at which time the entire orbital portion of the nerve is removed, along with the globe. 12. Leber, T.: Die Geschwulstbildungen der Netzhaut , in Graefe, A., and Saemisch, T.: Handbuch der gesammten Augenheilkunde , Leipzig, Wilhelm Engelmann, 1916, vol. 7, pp. 1723-1943. 13. Adam, C.: Statistisches, Klinisches und Anatomisches über das Glioma retinae , Ztschr. f. Augenh. 25:330-350, 1911. 14. Merriam, G. R.: Retinoblastoma: An Autopsy Analysis of 15 Cases, to be published. 15. Almost any length of nerve may be secured at operation if the following procedure is practiced: Pass a heavy silk traction suture through the insertion stumps of the internal and external rectus muscles, engaging some of the adjacent sclera. When the optic nerve is cut, pull the globe forcibly outward with the traction sutures, placing the optic nerve on a stretch, and at the same time press the blades of the scissors backward along the nasal wall of the orbit. 16. The optic nerve should be severed from the globe flush with the sclera immediately after the enucleation. Sections for microscopic study should be cut from the proximal, distal and central portions of the nerve to determine whether there has been tumor extension and, if so, whether or not the operative section has been made beyond it.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Nov 1, 1948

References