Retinoblastoma is a tumor that develops in the retina – the mucous membrane inside the eye. The retina is composed of nerve tissue and sends signals through the optic nerve to the brain where they are interpreted as the image signals.


Prof. Itzhak Hemo -Head of Retina Center, Hadassah Medical Center, Jerusalem.


Prof. Jacob Peer – Head of the Eye Cancer Department, Hadassah Medical Center.


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Diagnosis and treatment of retinoblastoma

Retinoblastoma usually affects young children but sometimes it may also occur in adults. This is a malignant disease that is subject to compulsory treatment from experienced professionals. Retinoblastoma is also a hereditary disease, it is a rare form of cancer that can occur in one or both eyes.


Symptoms of retinoblastoma:

white in the center circle of the eye (pupil) as a flash when taking pictures, redness, swelling

If you notice any changes in your child’s eyes, please see the doctor. If you have a family history of retinoblastoma, an experienced specialist should inform you about when a child should undergo regular screening for the prevention of the disease.


Factors of retinoblastoma

Retinoblastoma occurs when nerve cells in the retina develop genetic mutations that stimulate the growth of abnormal cells after the death of healthy. This accumulated mass of cells forms a tumor. Retinoblastoma cells can penetrate into the eye and related structures. Retinoblastoma can also spread (metastasize) to other parts of the body, including the brain and spinal cord.
Hereditary retinoblastoma is passed from parent to child in an autosomal dominant pattern which means that only one of the parents must have one copy of the mutated gene that leads to an increased risk of retinoblastoma in children. If one parent carries the gene mutation the child has a 50 percent chance of inheriting the gene.
Although the genetic mutation increases the risk it does not mean that cancer is inevitable.
Consult our doctor if the child has any signs and symptoms of eye problems that bother you.


Diagnosis of retinoblastoma

Eye examination. Ophthalmologist hold eye examination to determine the cause of symptoms in the child.
Visual tests. Scanning and other imaging tests help our specialists to determine whether increased retinoblastoma and affected by whether other structures around the eyes. Such a diagnosis may include ultrasound tomography (CT) and magnetic resonance, computerized tomography (MRT).
Consultations with other specialists. Child’s doctor may refer you to another doctor who specializes in treating cancer (oncologist), a clinical geneticist or surgeon.


Treatment of retinoblastoma

Determine the most effective method of treatment of retinoblastoma depends on the size and location of the tumor as well as extending it to other structures, the overall health of your child and your preference in the treatment. Our experts will do their best to save the child’s perspective.


Chemotherapy is a drug treatment that uses chemicals to destroy cancer cells. Chemotherapy may be in the form of tablets or infusions.
Children with retinoblastoma chemotherapy helps reduce swelling. Chemotherapy may be used in combination with radiation therapy, cryotherapy, thermotherapy or laser treatment. Chemotherapy may also be used for treating retinoblastoma has spread to other tissues.


Radiation therapy uses high-energy x-rays to destroy cancer cells.

Brachytherapy (local exposure). This method is most common. In the damaged layer of the eye is placed plate with radioactive material and remains there for a few days according to a calculation individually determined for each patient. The plate itself is a source of radiation and the radiation is only to increase following ocular tissues. Removing the plate and performance evaluation is performed under local anesthesia.

External exposure. Unlike local radiation from an external radiation source may be projected on the distant tissue.


The laser method. The laser is used to destroy blood vessels that supplies oxygen and nutrients to the tumor. Without this source the cancer cells cannot exist.


Cryotherapy. Use extreme cold to destroy cancer cells. During cryotherapy liquid nitrogen is placed near the cancer cells. Once cells are frozen the cold material is removed whereby thaw cells. This process of freezing and thawing is repeated several times during a session of cryotherapy causing the death of cancer cells.


Thermal treatment (thermotherapy). Thermotherapy uses a large amount of heat to destroy cancer cells. Heat rays are directed to the cancerous cells by ultrasound, laser or microwaves.


Surgical method. Surgery may be recommended by doctor in case of too large size of the tumor. In such situations it may be considered the operation to remove the eye, which can help prevent the spread of cancer to other parts of the body. After this operation is performed reconstructive surgery and implant set.


Immunotherapy and biological treatment for retinoblastoma is a new more advanced, effective and safer treatment method.



Prevention of retinoblastoma

For families with a history of retinoblastoma case one of the surest ways to prevent the appearance or progression of the disease is genetic testing, which will help parents learn about their child’s risk of disease that can begin at an early age. Thus, the diagnosis of retinoblastoma can be delivered very early, when the tumor is small in size and the probability of preservation is very high.
If a genetic test determines that the child has retinoblastoma is caused by a hereditary genetic mutation, your family should consult a specialist in genetics.
Genetic testing is performed in order to determine:
– If the child with retinoblastoma has a danger of other cancers
– If there are other children in the family risk of developing retinoblastoma and other cancers associated with it, which leads to need of regular tests in children at an early age
– Whether there is a risk of disease transmission by one of the partners of a genetic mutation future children


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