An Intraocular Pressure Predictive of High-Risk Histopathologic Features in Group E Retinoblastoma Eyes

Abstract

Purpose : To determine the intraocular pressure (IOP), with or without neovascularization of the iris (NVI), that most accurately predicts the presence of high-risk histopathologic features, including post-laminar optic nerve invasion, massive choroidal invasion, and extra-scleral invasion.

Methods : A retrospective chart review was done on 118 enucleated Group E eyes with numerical IOP recorded at diagnosis and documentation of the presence or absence of high-risk histopathologic features.

Results : The mean IOP at diagnosis for eyes with high-risk pathology (31.8 mm Hg) was significantly higher than the mean IOP at diagnosis for eyes without high-risk pathology (24.5 mm Hg) (p = 0.0031). An IOP cutoff value of 34 mm Hg optimizes specificity (82.4%) in predicting the presence of high-risk histopathologic features, as eyes with an IOP ≥ 34 mm Hg at diagnosis were 5.91 times more likely to have high-risk histopathologic features than those with an IOP < 34 mm Hg at diagnosis. Furthermore, having an IOP ≥ 34 mm Hg at diagnosis was more predictive of high-risk histopathology than either the presence or absence of NVI.

Conclusions : Whether or not NVI occurs, Group E eyes with an IOP ≥ 34 mm Hg at diagnosis are 5.91 times more likely to have high-risk histopathologic features than eyes with an IOP below this value. Thus, any attempts at salvage or unnecessary delay in enucleation for these eyes may predispose the child to unnecessary metastatic risk.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.