Saumya Jakati1, Vijitha S Vempuluru2, Ashik Mohamed3, Dilip K Mishra1, Swathi Kaliki2. 1. Ophthalmic Pathology Laboratory (SJ, DKM), L V Prasad Eye Institute, Hyderabad, India. 2. The Operation Eyesight Universal Institute for Eye Cancer (VSV, SK), L V Prasad Eye Institute, Hyderabad, India. 3. Ophthalmic Biophysics (AM), L V Prasad Eye Institute, Hyderabad, India.
Abstract
PURPOSE: To evaluate the lenticular changes in advanced intraocular retinoblastoma (RB) and identify the risk factors for cataract in these eyes. METHODS: Retrospective analysis of 48 primary enucleations. RESULTS: All enucleated eyes were classified either as group D (n = 7; 15%) or group E (n = 41; 85%) tumors based on the International Classification of Intraocular Retinoblastoma. Of the 48 enucleated eyes with RB, cataract was noted clinically in only 5 (18%) cases, while histopathology revealed cataractous changes in 28 (58%) cases. Based on histopathology, the cataractous changes included anterior subcapsular cataract (n = 10; 36%), cortical cataract (n = 6; 21%), posterior subcapsular cataract (n = 10; 36%) and both anterior and posterior subcapsular cataract (n = 2; 7%). Based on multivariate logistic regression, only increased area of necrosis on histopathology was the significant (p = .009) factor predictive of cataractous changes in lens with an odds ratio of 1.08. CONCLUSION: Eyes with advanced RB can harbor cataract in 58% cases, though most of these are subclinical. Clinically significant cataract may be evident in only 18% cases. Increased tumor necrosis is associated with the development of cataractous changes in RB cases.
PURPOSE: To evaluate the lenticular changes in advanced intraocular retinoblastoma (RB) and identify the risk factors for cataract in these eyes. METHODS: Retrospective analysis of 48 primary enucleations. RESULTS: All enucleated eyes were classified either as group D (n = 7; 15%) or group E (n = 41; 85%) tumors based on the International Classification of Intraocular Retinoblastoma. Of the 48 enucleated eyes with RB, cataract was noted clinically in only 5 (18%) cases, while histopathology revealed cataractous changes in 28 (58%) cases. Based on histopathology, the cataractous changes included anterior subcapsular cataract (n = 10; 36%), cortical cataract (n = 6; 21%), posterior subcapsular cataract (n = 10; 36%) and both anterior and posterior subcapsular cataract (n = 2; 7%). Based on multivariate logistic regression, only increased area of necrosis on histopathology was the significant (p = .009) factor predictive of cataractous changes in lens with an odds ratio of 1.08. CONCLUSION: Eyes with advanced RB can harbor cataract in 58% cases, though most of these are subclinical. Clinically significant cataract may be evident in only 18% cases. Increased tumor necrosis is associated with the development of cataractous changes in RB cases.