A one year old child having leucocoria was detected to be having a unilateral, large retinoblastoma filling half the globe. Which of the following is the therapy of choice?
Since the child is having a very large retinoblastoma filling more than half the globe the treatment of choice is enucleation. Eyeball is enucleated along with maximum length of the optic nerve without perforating the eyeball. Enucleation is indicated in the treatment of retinoblastoma when the tumor involves more than half the retina, optic nerve is involved and when glaucoma is present and anterior chamber is involved. Ref: Comprehensive Ophthalmology By AK Khurana, 4th Edition, Page 283.
Enucleation
Chemotherapy followed by local dyes
Scleral radiotherapy followed by chemotherapy
Direct Laser ablation using photo dynamic cryotherapy