Persistence of Subretinal Fluid and the Risk of Enucleation in Group D Retinoblastoma Eyes

Abstract

Purpose: To evaluate the association of persistent subretinal fluid (SRF) and the need for enucleation in Group D eyes of bilateral retinoblastoma treated with chemoreduction.

Methods: 53 Group D eyes were evaluated for the presence of SRF at diagnosis. They were subsequently treated with primary chemoreduction, using a 3 drug chemotherapy regimen. Globe survival analysis was used to evaluate whether persistence of subretinal fluid was associated with persistent tumor activity after chemoreduction and a worse overall outcome (i.e. enucleation). Logistic regression analysis was used to assess the association between duration of SRF and risk for enucleation.

Results: 79.25% (n=42) of Group D eyes exhibited SRF at diagnosis. Of these 42 eyes, 25 eyes showed subretinal fluid that persisted after the first round of chemotherapy. 9 eyes demonstrated continued SRF after 3 cycles of chemotherapy and 2 eyes continued with fluid at 6 months. Ten eyes ultimately required enucleation (10/53 or 18.9%). Only one of the 10 enucleated eyes demonstrated persistent SRF at the time of enucleation. 8 of 10 eyes contained histologic evidence of viable tumor cells. There was no statistically significant association between the persistence of SRF and risk for enucleation.

Conclusions: We hypothesized that the persistence of subretinal fluid during chemotherapy was a risk factor for enucleation. However, the duration of SRF was not found to be an independent predictor of whether Group D eyes will ultimately require enucleation following chemoreduction.