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Abstract
To study the clinical presentation, treatment, and outcomes of patients with bilateral
advanced intraocular retinoblastoma. Retrospective case series of 72 patients. The
mean age at presentation was 19 months. Leukocoria ( n = 49, 68%) was the most common
presenting complaint. The tumors were classified as groups D ( n = 60, 42%) or E
( n = 84, 58%) based on the Philadelphia version of International Classification
of Retinoblastoma (ICRB); groups D ( n = 84, 58%) or E ( n = 60, 42%) based on Children’s
Hospital Los Angeles version of International Classification of Intraocular Retinoblastoma
(ICIoR); T2 ( n = 116, 81%) or T3 ( n = 28, 19%) based on 8th edition American Joint
Committee Classification (AJCC). Systemic chemotherapy ( n = 138, 96%) was the most
common primary treatment modality. The chance of globe salvage was higher for group
D based on ICRB (83%; odds ratio (OR) 7.73; 95% confidence interval (CI) 3.45–17.33)
or ICIoR (81%; OR 12.75; 95% CI 5.74–28.34) and T2b (73%; OR 5.19; 95% CI 2.51–10.73)
based on AJCC. Over a mean follow-up period of 59 months, tumor recurrence was noted
in 42 (29%) eyes and globe salvage was achieved in 83 (58%) eyes. Of the 50 eyes where
vision was recorded, vision of 20/200 or better was achieved in 24 (48%) eyes. There
were events of leukemia ( n = 1, 1%), pinealoblastoma ( n = 1, 1%), systemic metastasis
( n = 3, 4%), and death ( n = 4, 6%) during the follow-up period. Multimodality
treatment allows globe salvage (58%) and vision salvage (48%) in eyes with advanced
group D and E intraocular retinoblastoma.