Does vitreous haemorrhage and calcification lead to increased risk of enucleation in advanced retinoblastoma?

IF 3 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2023-07-11 DOI:10.1111/aos.15735

Mengjia He, Ludi Yang, Shichong Jia, Jie Yang, Xuyang Wen, Jiayan Fan, Renbing Jia, Xianqun Fan

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引用次数: 0

Abstract

Purpose

To explore whether varying degrees of vitreous haemorrhage (VH) and calcification act as risk factors for enucleation in patients with advanced retinoblastoma (RB).

Methods

Advanced RB was defined by the international classification of RB (Philadelphia version). Basic information for retinoblastoma patients diagnosed as groups D and E in our hospital between January 2017 and June 2022 was reviewed by logistics regression models. Additionally, a correlation analysis was performed, excluding variables with a VIF (variance inflation factor) >10 from the multivariate analysis.

Results

A total of 223 eyes diagnosed with RB were included in assessing VH and calcification; of these, 101 (45.3%) eyes experienced VH, and 182 (76.2%) eyes were found to have calcification within the tumour through computed tomography (CT) or B-scan ultrasonography. Ninety-two eyes (41.3%) were enucleated, of which 67 (72.8%) had VH and 68 (73.9%) calcification, both of which were significantly relevant to enucleation (p < 0.001*). Other clinical risk factors, such as corneal edema, anterior chamber haemorrhage, high intraocular pressure during treatment and iris neovascularization, correlated significantly with enucleation (p < 0.001*). Multivariate analysis included IIRC (intraocular international retinoblastoma classification), VH, calcification and high intraocular pressure during treatment as independent risk factors for enucleation.

Conclusions

Despite identifying different potential risk factors for RB, there remains significant controversy concerning which patients require enucleation, and the degree of VH varies. Such eyes need to be evaluated carefully, and management with appropriate adjuvant therapy may improve the outcome of these patients.

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玻璃体出血和钙化是否会增加晚期视网膜母细胞瘤的去核风险？

目的探讨不同程度的玻璃体出血（VH）和钙化是否是晚期视网膜母细胞瘤（RB）患者进行去核手术的风险因素。方法根据国际视网膜母细胞瘤分类（费城版）定义晚期视网膜母细胞瘤。通过物流回归模型回顾了2017年1月至2022年6月在我院确诊为D组和E组的视网膜母细胞瘤患者的基本信息。此外，还进行了相关性分析，将VIF（方差膨胀因子）>10的变量排除在多变量分析之外。结果共有223只确诊为RB的眼睛被纳入VH和钙化评估；其中101只（45.3%）眼睛出现VH，182只（76.2%）眼睛通过计算机断层扫描（CT）或B扫描超声波检查发现肿瘤内有钙化。92只眼睛（41.3%）进行了去核，其中67只（72.8%）有VH，68只（73.9%）有钙化，这两种情况都与去核有显著相关性（p <0.001*）。其他临床风险因素，如角膜水肿、前房出血、治疗期间眼压过高和虹膜新生血管等，也与去核显著相关（p <0.001*）。多变量分析将 IIRC（眼内国际视网膜母细胞瘤分类）、VH、钙化和治疗期间高眼压列为去核的独立风险因素。结论尽管发现了RB的不同潜在风险因素，但关于哪些患者需要去核仍存在很大争议，VH的程度也各不相同。需要对这类患者的眼睛进行仔细评估，采用适当的辅助治疗可能会改善这些患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.