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10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye. You and Dr. Shields have been seeing her periodically. On a recent visit she saw you and you were concerned about a possible change in one of the lesions and suggested she come in here for an evaluation. I apparently saw her as a baby. I do not have those records. I have not seen her since. VISUAL ACUITY: OD 20/25, OS 20/300. IOP: OD 12, OS 11. SLIT LAMP EXAM: The lenses are clear. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. The vessels are tortuous coming out of the optic nerve, somewhat nasally and inferonasally. I saw multiple areas of cryotherapy in the periphery at 12 o’clock, 1 – 2 o’clock, at 4 o’clock, 6 o’clock, 7 o’clock, 7:30, and at 9 o’clock where peripheral tumors were treated. There were two areas of cottage cheese-type 1 regression of the retinoblastoma. One was a large area at 3 o’clock and one was an area in the periphery inferotemporally at 7 o’clock. I did not see anything that looked active. OS: Vertical C/D ratio is 0.0. There is a large lesion involving the macula and inferior to the optic nerve, which has a combination of type 1 and type 2 cottage cheesy and fleshy regression. There are multiple areas of cryotherapy in the periphery, one at 12 o’clock, one between 1 and 2 o’clock and one at 3 o’clock. There are areas of stippled chorioretinal scarring in the inferotemporal periphery and then there is the cottage cheesy lesion just inferior to the optic nerve. The edges of this lesion all appear sharp. I did not see any extension out of any of the edges of any of the lesions. I have taken extensive photographs and I made a montage of the photographs which I am going to email to Dr. Shields. IMPRESSION: 1. BILATERAL TREATED RETINOBLASTOMA – BOTH EYES 2. CHORIORETINAL SCARRING INVOLVING – BOTH EYES, INVOLVING THE MACULA OF THE LEFT EYE DISCUSSION: I explained to the patient and the family that I do not see anything that looks active and at age 10 it would be extremely unusual for her to have late recurrence. I did email the photos I took to Dr. Shields at his practice.

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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy279 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy173 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy134 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy119 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy140 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy172 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy134 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy82 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy93 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy132 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy116 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy105 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy112 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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Retinoblastoma - Bilateral - Regressed - Chemotherapy, Thermal Therapy, Cryotherapy169 views10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye00000
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10-year-old child was seen in the office on August 6, 2008. She was treated with a combination of chemotherapy at 10 months old as well as thermal therapy and cryotherapy for bilateral retinoblastoma tumors. She reportedly had nine tumors in the left eye and five tumors in the right eye. You and Dr. Shields have been seeing her periodically. On a recent visit she saw you and you were concerned about a possible change in one of the lesions and suggested she come in here for an evaluation. I apparently saw her as a baby. I do not have those records. I have not seen her since. VISUAL ACUITY: OD 20/25, OS 20/300. IOP: OD 12, OS 11. SLIT LAMP EXAM: The lenses are clear. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. The vessels are tortuous coming out of the optic nerve, somewhat nasally and inferonasally. I saw multiple areas of cryotherapy in the periphery at 12 o’clock, 1 – 2 o’clock, at 4 o’clock, 6 o’clock, 7 o’clock, 7:30, and at 9 o’clock where peripheral tumors were treated. There were two areas of cottage cheese-type 1 regression of the retinoblastoma. One was a large area at 3 o’clock and one was an area in the periphery inferotemporally at 7 o’clock. I did not see anything that looked active. OS: Vertical C/D ratio is 0.0. There is a large lesion involving the macula and inferior to the optic nerve, which has a combination of type 1 and type 2 cottage cheesy and fleshy regression. There are multiple areas of cryotherapy in the periphery, one at 12 o’clock, one between 1 and 2 o’clock and one at 3 o’clock. There are areas of stippled chorioretinal scarring in the inferotemporal periphery and then there is the cottage cheesy lesion just inferior to the optic nerve. The edges of this lesion all appear sharp. I did not see any extension out of any of the edges of any of the lesions. I have taken extensive photographs and I made a montage of the photographs which I am going to email to Dr. Shields. IMPRESSION: 1. BILATERAL TREATED RETINOBLASTOMA – BOTH EYES 2. CHORIORETINAL SCARRING INVOLVING – BOTH EYES, INVOLVING THE MACULA OF THE LEFT EYE DISCUSSION: I explained to the patient and the family that I do not see anything that looks active and at age 10 it would be extremely unusual for her to have late recurrence. I did email the photos I took to Dr. Shields at his practice.