Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Pediatr Blood Cancer. 2012 Mar;58(3):356-61. doi: 10.1002/pbc.23239. Epub 2011 Jun 30.
Previous studies show that clinical features at presentation, in retinoblastoma patients, like glaucoma and neovascularization of iris are associated with a higher incidence of high risk histopathology findings (HRF) in enucleated eyes. Herein, we analyze association between clinical features at time of enucleation and occurrence of HRF including invasion of anterior chamber, iris, ciliary body, choroid (massive), sclera, extrascleral tissue, optic nerve beyond lamina cribrosa, and optic nerve cut end, in a large series of eyes enucleated for retinoblastoma.
We retrospectively studied demographic, clinical, and histopathology findings in all retinoblastoma patients who underwent primary enucleation at our center, over a 5 years duration. Statistical analysis was done to find any association between clinical features at presentation and the presence of HRF.
Three hundred twenty-six eyes were studied. Median age of presentation was 2 years. Glaucoma was the most common clinical finding at presentation apart from leucocoria. Out of 326 enucleated eyes, 28 (8.6%) had extrascleral and/or optic nerve transection invasion. Among remaining 298 eyes, with completely resected tumor, 115 (38.6%) had massive choroidal invasion, 54 (17%) had retrolaminar optic nerve invasion, and 24 (7%), 29 (9%), and 23(7%) had anterior chamber, iris, and ciliary body invasion, respectively. Age more than 2 years, lag period more than 3 months, hyphema, pseudohypopyon, staphyloma, and orbital cellulitis were associated with occurrence of three or more HRF on univariate analysis.
Clinical variables including older age, longer lag period, hyphema, pseudohypopyon, staphyloma, and orbital cellulitis were strongly associated with occurrence of HRF in this study.
先前的研究表明，在患有视网膜母细胞瘤的患者中，就诊时的临床特征，如青光眼和虹膜新生血管化，与眼内容剜除术后发生高危组织病理学发现（HRF）的发生率较高有关。在此，我们分析了在大型眼内容剜除系列中，眼球摘除时的临床特征与 HRF 的发生之间的关系，包括前房、虹膜、睫状体、脉络膜（弥漫性）、巩膜、眼外组织、超过筛板的视神经和视神经切断端的侵犯。
我们回顾性研究了在我们中心接受初次眼内容剜除术的所有视网膜母细胞瘤患者的人口统计学、临床和组织病理学发现，研究时间为 5 年。进行了统计学分析，以发现就诊时的临床特征与 HRF 存在之间的任何关联。
研究了 326 只眼睛。就诊时的中位年龄为 2 岁。除了白瞳症外，青光眼是最常见的就诊时的临床表现。在 326 只眼内容剜除的眼中，28 只（8.6%）有眼外组织和/或视神经横断侵犯。在其余 298 只肿瘤完全切除的眼中，115 只（38.6%）有弥漫性脉络膜侵犯，54 只（17%）有视盘后视神经侵犯，24 只（7%）、29 只（9%）和 23 只（7%）分别有前房、虹膜和睫状体侵犯。年龄大于 2 岁、潜伏期大于 3 个月、前房积血、假性前房积脓、葡萄肿和眶蜂窝织炎在单变量分析中与 3 种或更多 HRF 的发生相关。
在这项研究中，年龄较大、潜伏期较长、前房积血、假性前房积脓、葡萄肿和眶蜂窝织炎等临床变量与 HRF 的发生密切相关。
