[Analysis of the histopathological features of recurrent retinoblastoma after vitrectomy]

Objective: To analyze the histopathological features and histopathological risk factors (HRF) of tumor recurrence after vitrectomy in patients with retinoblastoma (RB). Methods: Retrospective case series. Twenty-nine patients (29 eyes) who underwent enucleation from April 2014 to April 2019 at the Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University due to tumor recurrence after vitrectomy in the other hospitals were enrolled and archived. The pathological sections of the other hospitals were read by the pathologists of the department and the pathological report was written. Histopathological features and HRF were analyzed in this group of patients. The HRF used in this study was defined as tumor invasion of the optic nerve, the choroid (the largest diameter ≥ 3 mm and mostly reaching the inner sclera), the sclera, the anterior segment of the eye, and tumor passing through the scleral and growing outside the eyeball. Results: Of the 29 patients with RB recurrence after vitrectomy, 18 (62.1%) were male and 11 (37.9%) were female. The age was 1-10 years with a median age of 3 years. Among 29 eyes, the tumor invaded the ciliary body in 19 eyes (65.5%), the iris in 14 eyes (48.3%), the anterior chamber in 10 eyes (34.5%), and the anterior chamber angle in 7 eyes (24.1%). Of the 29 eyes, 27 eyes (93.1%) had HRF. The most common HRF was invading the anterior segment of the eye(77.8%, 21/27). Conclusions: In patients with recurrence after vitrectomy for RB, the most common tumor invasion site in histopathology is the anterior segment of the eye, particularly the ciliary body. More than 90% of the patients have HRF. Vitrectomy for RB treatment requires a rigorous surgical indication assessment. (Chin J Ophthalmol, 2019, 55: 854-859).