Clinical and Pathological Predictor Factors of Fellow Eye Affliction in Patients with an Initial Unilateral Retinoblastoma

Mohamed A Ibrahim,Mansour Al-Mohaimeed

doi:10.4172/2155-9570.1000205

Abstract

Objective:To identify the clinical and pathological predictor factors for the fellow eye affliction (asynchronous bilateralization) in patients who were initially diagnosed with unilateral retinoblastoma. Methods:The present study was conducted in the Department of Ophthalmology of the Faculty of Medicine at Zagazig University in Zagazig, Egypt. All patients initially diagnosed with unilateral retinoblastoma from January 2005 to December 2007 were followed up meticulously for at least 32 months for the development of metastatic disease and/or fellow eye affliction. At pathological examination, all specimens were stained with hematoxylin (HX) and eosin (E). The specimens also underwent special immunohistochemical staining for neuron-specific enolase (NSE). Care was given to detect optic nerve invasion by the tumor, tumor focality, and tumor differentiation during pathological examination. Results: Only 3 (16.7%) of the 18 patients initially diagnosed with unilateral retinoblastoma developed a fellow eye affliction, asynchronous bilateralization of retinoblastoma, during the follow-up period. The time lapse to fellow eye affliction ranged from 3 to 14 months. All 3 patients (100%) were diagnosed at less than 12 months of age (mean, 6.3 months; P 0.05). Of the 3 patients, 2 (66.7%) had a positive family history of retinoblastoma (P < 0.05). Optic nerve invasion and poor tumor differentiation were found in 2 (66.7%) and 1 (33.3%), respectively, of the 3 patients with asynchronous bilateralization. A statistically significant correlation was found between negative NSE staining and asynchronous bilateralization of retinoblastoma (P < 0.05). Conclusions:This study suggests that earlier age at diagnosis (less than 1 year), positive family history, and negative immunohistochemical staining with NSE are possible predictor factors for the development of fellow eye affliction in patients initially diagnosed with unilateral retinoblastoma.

Highlights

This study suggests that earlier age at diagnosis, positive family history, and negative immunohistochemical staining with neuron-specific enolase (NSE) are possible predictor factors for the development of fellow eye affliction in patients initially diagnosed with unilateral retinoblastoma
The aim of this study is to identify the clinical and pathological predictor factors for the affliction of the fellow eye in patients with initial unilateral retinoblastoma in our locality
All 3 (100%) patients with asynchronous bilateralization of retinoblastoma were initially diagnosed with a unilateral retinoblastoma before the age of 12 months, whereas 3 (20%) of the 15 patients without a fellow eye affliction were initially diagnosed with a unilateral retinoblastoma before the age of 12 months

Summary

Methods

All patients initially diagnosed with unilateral retinoblastoma from January 2005 to December 2007 were followed up meticulously for at least 32 months for the development of metastatic disease and/or fellow eye affliction. A series of 18 patients were initially diagnosed with unilateral retinoblastoma in Department of Ophthalmology at the Faculty of Medicine, Zagazig University in Zagazig, Egypt, from January 2005 to December 2007 with follow up period meticulously for at least 32 months. All patients were followed up meticulously for at least 32 months for the detection of recurrence, metastatic disease, or fellow eye affliction If any of these conditions were detected, metastatic workup and repeated careful examinations of both eyes were performed (sometimes under general anesthesia)

Results

Discussion

Conclusion