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A clinicopathological correlation of 67 eyes primarily enucleated for advanced intraocular retinoblastoma
  1. Matthew W Wilson1,2,3,
  2. Ibrahim Qaddoumi4,5,
  3. Catherine Billups6,
  4. Barrett G Haik1,2,
  5. Carlos Rodriguez-Galindo4,5
  1. 1Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  2. 2Department of Surgery, Division of Ophthalmology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
  3. 3Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
  4. 4Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  5. 5Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
  6. 6Department of Biostatics, St Jude Children's Research Hospital, Memphis, Tennessee, USA
  1. Correspondence to Dr Matthew W Wilson, Hamilton Eye Institute, 930 Madison Ave, Room 476, Memphis, TN 38163, USA; mwilson5{at}uthsc.edu

Abstract

Aims To correlate the clinical and histopathological findings of eyes primarily enucleated for advanced intraocular retinoblastoma.

Methods In a retrospective study, the authors identified patients primarily enucleated for advanced intraocular retinoblastoma. The authors retrieved patient demographics, clinical findings, subsequent treatments and outcomes, and reviewed the histopathology of each eye for invasion of the anterior chamber, iris, ciliary body, choroid, sclera and optic nerve, and extraocular extension. The authors used the Fisher exact, exact Jonkheere–Terpstra, exact Wilcoxon rank sum and Kruskal–Wallis statistical tests (p<0.05) to study associations between clinical and histopathological findings.

Results The authors identified 67 eyes of 67 patients (33 males) primarily enucleated for retinoblastoma between March 1997 and January 2008. Corneal diameter, intraocular pressure and Reese–Ellsworth Classification had no significant association with invasive disease. The International Classification, however, was associated with optic nerve (p=0.026), choroid (p<0.001), ciliary body (p=0.002), iris (p=0.002), anterior chamber (p=0.025) and scleral (p<0.001) invasion. Eyes classified as International Classification Group E were more likely to have invasion of these sites and have more severe optic-nerve invasion.

Conclusions Corneal diameter, intraocular pressure and Reese–Ellsworth Classification do not correlate with histopathological evidence of invasive retinoblastoma. Eyes classified as International Classification Group E are more likely to have elevated intraocular pressure, invasion of the anterior chamber, uveal tract, optic nerve and sclera. The findings warrant primary enucleation with meticulous histopathological examination of such eyes prior to any adjuvant therapy.

  • Retin oblastoma
  • adjuvant therapy
  • enucleation
  • histopathology
  • International Classification
  • retina
  • pathology
  • treatment surgery
  • child health (paediatrics)

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Footnotes

  • Presented at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, 4 May 2009

  • Funding For financial support, we thank Research to Prevent Blindness, New York, and the St Giles Foundation, New York.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the University of Tennessee Health Science Center and St Jude Children's Research Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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