Screening Guidelines for Retinoblastoma

An expert panel of ocular oncologists, pathologists and geneticists has established guidelines that could facilitate care and eliminate unnecessary exams for children at risk of retinoblastoma. In this interview from AAO 2017, 2 members of this panel—Drs. Alison Skalet and Patricia Chevez-Barrios—discuss the take-home points from the consensus statement. Published recently in Ophthalmology, the main recommendations were:

• At-risk children should undergo genetic testing
• The child’s age and risk level should determine the frequency of serial dilated fundus exams, which should be performed by a physician
• Newborns at high (>7.5%) risk of Rb should be screened every 2 to 4 weeks during their first 2 months of life, whereas newborns with intermediate (1%-7.5%) or low (<1%) risk should be screened monthly.
• Necessary exam frequency declines as the child ages and may be discontinued at age 7 for children without an RB1 mutation
• Children who carry an RB1 mutation should be screened indefinitely, every 1 to 2 years.

The findings were endorsed by the American Association of Ophthalmic Oncologists and Pathologists (AAOOP), the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), the American Academy of Ophthalmology (AAO), the American Society of Pediatric Hematology/Oncology (ASPHO) and the American Academy of Pediatrics (AAP). 

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