Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

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

Mohamed A. Ibrahim and Mansour Al-Mohaimeed

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 < 0.001). Only 1 (33.3%) of the 3 patients had a multifocal tumor (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.