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A. H. Shaikh, C. C. Simões, Z. M. Corrêa, J. J. Augsburger; How Good Are Office Examinations for Identifying Extent of Intraocular Retinoblastoma?. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2073.
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The purpose of this study is to determine how frequently and by how much the clinical findings and classification of retinoblastoma identified at initial office examination (OE) differed from those determined by EUA.
Retrospective review of clinical records of 144 patients with retinoblastoma evaluated by the senior author (JJA) between 1980 and 2007. Patients who received any treatment prior to initial OE or had their initial EUA following treatment were excluded from the study (n=71). Fundus drawings, anterior segment drawings, and chart notations made by the senior author at baseline OE and subsequent EUA were reviewed. Retinoblastoma grouping by International Classification of Intraocular Retinoblastoma (ICIR) and sizes of all tumors and their distances from the optic disc identified at each examination were determined.
The records of 73 patients were suitable for analysis in this study. All patients had EUA within two weeks after initial OE. Retinal tumors not noted on OE were identified at EUA in only 9 of 146 eyes (6.1%). Of these 9 eyes, only 1 eye had foci of tumors <10 mm away from the optic disc. All tumor foci missed on OE were < 3.0 mm in diameter. No child was found to have vitreal or subretinal seeds on EUA that were undetected on OE. Two of the 146 eyes (1.3%), both of which were felt to be normal on OE, were found to have small peripheral tumors on EUA and were categorized as ICIR group A eyes on the basis of the EUA findings.
Although many ophthalmologists who manage retinoblastoma patients perform only a cursory OE sufficient for presumptive diagnosis and defer ICIR classification and treatment discussions until after EUA, our study indicates that a comprehensive OE by an experienced examiner can provide most of the relevant information.
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