NEOVASCULAR GLAUCOMA AS A PREDICTOR of RETINOBLASTOMA HIGH-RISK HISTOPATHOLOGY in AN INTERNATIONAL MULTICENTER STUDY

Negretti G.S.; Ushakova T.; Yuri S.; Vladimir P.; Berry J.L.; Pike S.; Shields C.L.; Hubbard G.B.; Eiger-Moscovich M.; Pe'Er J.; Staffieri S.E.; Elder J.E.; McKenzie J.D.; Ahmad A.; Hussain M.; Casavilca-Zambrano S.; Alarcon-Leon S.; Yousef Y.A.; Mohammad M.; Tanabe M.; Arazi M.; Fabian I.D.; Goldstein S.; Kaliki S.; Sagoo M.S.; Reddy M.A. · Retina (2025) · DOI: 10.1097/iae.0000000000004340

Resumen

Purpose:To assess histopathology and outcomes after primary enucleation of eyes with retinoblastoma presenting with neovascular glaucoma (NVG).Methods:This was an international multicenter case series study across five continents. A retrospective review of patient charts was performed for all patients undergoing primary enucleation for retinoblastoma (n = 1,420) using a standardized data-collection spreadsheet. Clinical features, pathologic grade, and outcomes were compared between NVG patients and those with an American Joint Commission on Cancer eighth edition clinical stage of cT2. High-risk histopathology was defined as American Joint Commission on Cancer eighth edition pathologic stage ≥ pT2b.Results:Neovascular glaucoma was seen in 224/1,420 (16%) patients. The mean age at presentation of those with NVG was 30 months (median 25, range 0-120 months), and 131 (58%) patients had high-risk histopathology. The univariate logistic regression odds ratio for NVG predicting high-risk histopathology was 1.73 (95% confidence interval: 1.3-2.31) and from multivariate logistic regression was 1.77 (95% confidence interval: 1.23-2.56). Patients with a longer duration of symptoms (P = 0.03), buphthalmos (P = 0.02), and ectropion uveae (P < 0.01) were more likely to have high-risk histopathology. Patients with NVG were more likely to develop metastasis than cT2 patients (P = 0.04).Conclusion:There is a significant association between NVG at presentation, high-risk histopathology, and metastatic risk.