Open AccessClinical and histopathological correlation: A study on 334 eyes with retinoblastoma from Vietnam
Author(s) -
Ha Ngan Nguyen,
Van Trọng Pham,
Tuan Hoang,
Van Hong Pham,
Chung Ngoc Nguyen,
Tinh Xuan Nguyen,
Thuy Thi Bich Vu,
R. Max Conway
Publication year - 2016
Publication title -
asian journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 5
eISSN - 2452-0691
pISSN - 1560-2133
DOI - 10.35119/asjoo.v16i1.342
Subject(s) - medicine , hyphema , histopathology , ophthalmology , retrospective cohort study , optic nerve , ciliary body , surgery , glaucoma , pathology
Purpose: To elucidate the clinical features which predict high-risk histopathological factors for subsequent metastatic disease as well as to report the incidence of these high-risk histopathological factors in a cohort of Asian patients with retinoblastoma.
Design: A retrospective and non-randomized sequential cases series.
Methods: A retrospective study was done on 334 eyes with retinoblastoma at Vietnam National Institute of Ophthalmology during a 10 year period (January 2004 – December 2013). All pathology specimens and medical records were reviewed and assessed for invasion and clinical signs.
Results: Among 334 eyes, 225 (67.4%) had high-risk retinoblastoma and 109 (22.6%) had non-high-risk features on histopathology. The high-risk histopathological features included anterior chamber seeding (48.2%), iris infiltration (14.7%), ciliary body involvement (14.1%), massive choroidal invasion (29.9 %), post-laminar optic nerve invasion (21.2%), invasion of optic nerve transection (9.6 %), combined choroidal and optic nerve invasion (9.6 %), scleral invasion (3.3%), and extra-scleral infiltration (11.4%). The significant clinical features in high-risk group versus non-high-risk group included hyphema (19.6% vs 3.7%, p < 0.001), pseudohypopyon (19.1% vs 6.4%, p = 0.001), iris neovascularization (25.3% vs 5.5%, p < 0.001), vitreous seeding (72.4% vs 37.6%, p < 0.001), staphyloma (24% vs 4.6%, p < 0.001) and scleritis (20% vs 3.7%, p < 0.001).
Conclusions: Clinical signs including hyphema, pseudohypopyon, iris neovascularization, vitreous seeding, staphyloma, and scleritis were significantly associated with high-risk features on histopathology. Globe preserving methods should be used with caution in patients with these signs.