Aims To investigate the risk factors for cataract following eye-preserving therapies for retinoblastoma. Methods This retrospective, single-centre cohort study included patients diagnosed with retinoblastoma receiving eye-preserving therapies between January 2017 and June 2021. Cataract by the end of the follow-up was the main outcome. Results Cataract was found in 31 of 184 (16.8%) included eyes during a mean follow-up of 27.6 months. The cataract and control groups were similar regarding patients’ laterality, sex and disease stage. Eyes in the cataract group were more likely to present with endophytic retinoblastoma (p=0.02) and greater intraocular pressure (p=0.001). Competing risk regression analysis (univariate Fine-Gray model) showed that the growth pattern (p=0.01), intraocular pressure (p=0.01), number of intra-arterial chemotherapy (IAC) cycles (p=0.001), melphalan dose per IAC cycle (p=0.001) and number of intravitreous chemotherapy (IvitC) cycles (p=0.001) were associated with cataract occurrence. Multivariate analysis included higher intraocular pressure (p=0.003), a higher melphalan dose per IAC cycle (p=0.001) and an increasing number of IvitC cycles (p=0.04) as independent risk factors for cataract. Conclusions Repeated IAC and/or IvitC with melphalan were the most common eye-preserving therapies that induced cataract formation. The toxic effect of melphalan was an essential factor in cataract development, as indicated by the association of cataract occurrence with the melphalan dose. Data are available on reasonable request.

中文翻译：

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视网膜母细胞瘤治疗中白内障的危险因素

目的 探讨视网膜母细胞瘤保眼治疗后发生白内障的危险因素。方法 这项回顾性、单中心队列研究纳入了 2017 年 1 月至 2021 年 6 月期间接受保眼治疗的诊断为视网膜母细胞瘤的患者。随访结束时白内障是主要结局。结果 在平均 27.6 个月的随访期间，184 只眼睛中的 31 只 (16.8%) 发现了白内障。白内障组和对照组在患者偏侧性、性别和疾病阶段方面相似。白内障组的眼睛更有可能出现内生性视网膜母细胞瘤（p=0.02）和更高的眼压（p=0.001）。竞争风险回归分析（单变量 Fine-Gray 模型）显示生长模式 (p=0.01)、眼压 (p=0.01)、动脉内化疗 (IAC) 周期数 (p=0.001)、每次 IAC 的美法仑剂量周期（p=0.001）和玻璃体内化疗（IvitC）周期数（p=0.001）与白内障的发生相关。多变量分析包括较高的眼压（p=0.003）、每个IAC周期较高的美法仑剂量（p=0.001）和IvitC周期数量的增加（p=0.04）作为白内障的独立危险因素。结论 重复 IAC 和/或 IvitC 加美法仑是诱发白内障形成的最常见的护眼疗法。白内障发生与马法兰剂量之间的关系表明，马法兰的毒性作用是白内障发生的一个重要因素。可根据合理要求提供数据。