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Jasmine H Francis, Brian P Marr, David H Abramson; Clinical Characterization of Vitreous Seeds in Retinoblastoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3675.
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© ARVO (1962-2015); The Authors (2016-present)
Vitreous seeds can be distinguished into three morphologically distinct groups: dust (class I), spheres (class II) and clouds (class III). This present study evaluated whether there are additional clinical features that distinguish these classes of vitreous seeds, particularly with regard to age of patient, laterality of disease, intraocular tumor location, extent of disease and treatment status.
137 patient eyes with active vitreous seeds (either presenting for primary treatment with ophthalmic artery chemosurgery or with recurrent vitreous disease) were classified into three groups: dust, spheres and clouds. Eyes were excluded if there was an absence of active vitreous seeds or if vitreous hemorrhage precluded an assessment of the fundus or fundus photography was unavailable to judge vitreous seed status. Patient, disease and tumor characteristics were compared between classification groups. A two-tailed Fisher exact test and paired students’ t-test were used for statistical analysis.
Primary treated disease: With each successive seed class, the age of the patient is significantly older (p<0.05) seeds: median age for class I, II and III was 13.3, 20.1 and 39.3 mos, respectively. Eyes containing class III seeds were significantly more likely to occur in patients with unilateral disease (p<0.05), in the equator-ora region of the fundus (p<0.0001) and in a diffuse pattern (p<0.0001) compared to class I and II seeds. Recurrent disease: Recurrent vitreous seeds were significantly more common in patients with bilateral disease (p<0.001), occurred in the macula or macula-equator region of the fundus (p<0.001) and were class II (p<0.05).
The three classes of vitreous seeds have distinct clinical characteristics defined by extent and location of tumor producing seeds, laterality of disease and age of patient. In addition, recurrent vitreous seeds appear to have a unique clinical profile compared to those seeds receiving primary treatment.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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