Evaluation of high risk histopathology features in primary and secondary enucleated retinoblastoma-study of 136 cases in tertiary eye hospital

: Retinoblastoma is a childhood malignant intraocular tumor, necessitates a comprehensive treatment approach. Chemotherapy plays a crucial role in managing retinoblastoma. This study aims to evaluate and analyze high-risk histopathological features (HRF) in retinoblastoma cases initially treated with enucleation and those undergoing secondary enucleation after chemotherapy in a tertiary centre in western India.: This retrospective study was carried out in the pathology department, encompassing a total of 136 cases with enucleated eyes, spanning the period from Jan 2017 to Mar 2023. In the present study, all slides were retrieved and examined to gather information on demographics, laterality, choroid invasion, optic nerve invasion, anterior chamber invasion, tumor discrimination, chemotherapy effects, and tumor regression.In this study, the predominant presenting complaint was leukocoria (90%), with a slight female preponderance (53%), in comparison to males (47%). Unilateral cases accounted for 96%, while bilateral presentations were observed in 4% of cases. The mean age was 38 months, with 43% of eyes exhibiting significant choroid invasion and 27% showing invasion beyond the post-laminar optic nerve or resection margin. 76 patients (56%) underwent primary enucleation and 60 (44%) had secondary enucleation after chemotherapy. Out of the 60 patients with secondary enucleation, only 21 patients (35%) had HRF.We found late age of presentation of retinoblastoma in developing country like India. Higher incidence of HRFs in primary enucleated eyes than secondary enucleated eyes. Higher number of cases shows complete regression of tumor after chemotherapy.