Correlation of ocular ultrasonography with histopathologic findings in intraocular retinoblastoma

Objective: This study correlated the patterns of ocular B- and A-scans of intraocular retinoblastoma (RB) with corresponding histopathology sections. It aimed to establish a more objective basis for determining intraocular retinoblastoma by ultrasonography (UTZ) and to determine the degree of malignancy and viability of the tumor cells. Methods: New cases of retinoblastoma seen at the University of the Philippines-Philippine General Hospital (UP-PGH) from January 1994 to December 2003 were reviewed. Included were patients who underwent enucleation and whose eyeballs were processed at the UP Institute of Ophthalmology. Those with good quality ocular ultrasonographs (UTZ) and clear matching histopathologic sections were finally selected. Findings were correlated and analyzed.Results: Retinoblastoma (RB) showed multiplicity of lesions on UTZ corresponding to multiple lesions on histopathology. The following characteristic patterns were seen: Very malignant RB or pseudorosettes: fine, grainy densities on B-scan with short to medium broad spikes on A-scan ("V-W" pattern). Moderate differentiation with moderate necrosis and early calcific plaques: fine, dense grainy opacities on B-scan with multiple thin, high spikes admixed with tall, broad spikes of calcium deposits on A-scan. Well-differentiated RB with compact viable cells and no necrosis: large, white densities on B-scan with an initial high spike and high internal reflectivity, sometimes "plateauing," on A-scan with no calcific deposits. Complete tumor necrosis with calcific plaques: echolucent space with dense, white, plaque-like opacities on B-scan; flat or low spikes mixed with tall, broad spikes corresponding to calcium plaques on A-scan. Normal vitreous, serous subretinal fluid, or recent hemorrhage: echolucent area on B-scan with flat or low spikes on A-scan. Conclusion: The three most frequent findings in intraocular retinoblastoma were calcific plaques with liquefaction necrosis, multiplicity of lesions, and pseudorosettes. Ocular ultrasound of retinoblastoma showed good histopathologic correlation.

Epidemiological pattern of retinoblastoma at the Philippine General Hospital

Methods: This is a retrospective case series of new retinoblastoma patients seen at the University of the Philippines-Philippine General Hospital (UP-PGH) in three periods: 1967 to 1977, 1985 to 1995, and 1997 to 2001. The demographic and clinical characteristics of retinoblastoma over the three periods were compared. Results: The incidence of retinoblastoma increased from 40/100,000 new cases in 1967 to 1977 to 237/100,000 new cases in 1997 to 2001. The average age at onset did not change over time but the age at consultation decreased from 1.5 years to 1 year. The most common initial ocular manifestation at onset was cats eye reflex (77 to 79 percent) with findings of leukocoria (67 to 77 percent). Extraocular findings of proptosis and orbital mass declined through the years. Bilateral retinoblastoma comprised 30 percent in this series and showed no change in distribution over the years. Conclusion: The epidemiological and clinical patterns of retinoblastoma cases at the Philippine General Hospital may be changing over time and requires continuous monitoring of incidence and characteristics.