Abstract：
OBJECTIVE: To explore whether varying degrees of vitreous haemorrhage (VH) and calcification act as risk factors for enucleation in patients with advanced retinoblastoma (RB).
METHODS: Advanced RB was defined by the international classification of RB (Philadelphia version). Basic information for retinoblastoma patients diagnosed as groups D and E in our hospital between January 2017 and June 2022 was reviewed by logistics regression models. Additionally, a correlation analysis was performed, excluding variables with a VIF (variance inflation factor) >10 from the multivariate analysis.
RESULTS: A total of 223 eyes diagnosed with RB were included in assessing VH and calcification; of these, 101 (45.3%) eyes experienced VH, and 182 (76.2%) eyes were found to have calcification within the tumour through computed tomography (CT) or B-scan ultrasonography. Ninety-two eyes (41.3%) were enucleated, of which 67 (72.8%) had VH and 68 (73.9%) calcification, both of which were significantly relevant to enucleation (p < 0.001*). Other clinical risk factors, such as corneal edema, anterior chamber haemorrhage, high intraocular pressure during treatment and iris neovascularization, correlated significantly with enucleation (p < 0.001*). Multivariate analysis included IIRC (intraocular international retinoblastoma classification), VH, calcification and high intraocular pressure during treatment as independent risk factors for enucleation.
CONCLUSIONS: Despite identifying different potential risk factors for RB, there remains significant controversy concerning which patients require enucleation, and the degree of VH varies. Such eyes need to be evaluated carefully, and management with appropriate adjuvant therapy may improve the outcome of these patients.
METHODS: Advanced RB was defined by the international classification of RB (Philadelphia version). Basic information for retinoblastoma patients diagnosed as groups D and E in our hospital between January 2017 and June 2022 was reviewed by logistics regression models. Additionally, a correlation analysis was performed, excluding variables with a VIF (variance inflation factor) >10 from the multivariate analysis.
RESULTS: A total of 223 eyes diagnosed with RB were included in assessing VH and calcification; of these, 101 (45.3%) eyes experienced VH, and 182 (76.2%) eyes were found to have calcification within the tumour through computed tomography (CT) or B-scan ultrasonography. Ninety-two eyes (41.3%) were enucleated, of which 67 (72.8%) had VH and 68 (73.9%) calcification, both of which were significantly relevant to enucleation (p < 0.001*). Other clinical risk factors, such as corneal edema, anterior chamber haemorrhage, high intraocular pressure during treatment and iris neovascularization, correlated significantly with enucleation (p < 0.001*). Multivariate analysis included IIRC (intraocular international retinoblastoma classification), VH, calcification and high intraocular pressure during treatment as independent risk factors for enucleation.
CONCLUSIONS: Despite identifying different potential risk factors for RB, there remains significant controversy concerning which patients require enucleation, and the degree of VH varies. Such eyes need to be evaluated carefully, and management with appropriate adjuvant therapy may improve the outcome of these patients.
摘要：
目的：探讨不同程度的玻璃体出血（VH）和钙化是否是晚期视网膜母细胞瘤（RB）患者摘除的危险因素。
方法：高级RB由RB的国际分类（费城版本）定义。采用logistic回归模型对我院2017年1月至2022年6月诊断为D组和E组的视网膜母细胞瘤患者的基本信息进行回顾性分析。此外,进行了相关性分析，从多变量分析中排除VIF(方差膨胀因子)>10的变量。
结果：总共223只诊断为RB的眼睛被纳入评估VH和钙化；其中，101(45.3%)眼经历VH,通过计算机断层扫描（CT）或B超检查发现182只（76.2％）眼肿瘤内钙化。92只眼睛（41.3％）摘除，其中67例（72.8%）有VH，68例（73.9%）钙化，两者均与摘除术显著相关(p<0.001*).其他临床危险因素，如角膜水肿，前房出血,治疗期间的高眼压和虹膜新生血管，与眼球摘除显著相关(p<0.001*)。多因素分析包括IIRC（眼内国际视网膜母细胞瘤分类），VH,治疗期间钙化和高眼压是眼球摘除的独立危险因素。
结论：尽管发现了不同的RB潜在危险因素，关于哪些患者需要摘除，仍然存在重大争议，VH的程度各不相同。这样的眼睛需要仔细评估，适当的辅助治疗可以改善这些患者的预后。
方法：高级RB由RB的国际分类（费城版本）定义。采用logistic回归模型对我院2017年1月至2022年6月诊断为D组和E组的视网膜母细胞瘤患者的基本信息进行回顾性分析。此外,进行了相关性分析，从多变量分析中排除VIF(方差膨胀因子)>10的变量。
结果：总共223只诊断为RB的眼睛被纳入评估VH和钙化；其中，101(45.3%)眼经历VH,通过计算机断层扫描（CT）或B超检查发现182只（76.2％）眼肿瘤内钙化。92只眼睛（41.3％）摘除，其中67例（72.8%）有VH，68例（73.9%）钙化，两者均与摘除术显著相关(p<0.001*).其他临床危险因素，如角膜水肿，前房出血,治疗期间的高眼压和虹膜新生血管，与眼球摘除显著相关(p<0.001*)。多因素分析包括IIRC（眼内国际视网膜母细胞瘤分类），VH,治疗期间钙化和高眼压是眼球摘除的独立危险因素。
结论：尽管发现了不同的RB潜在危险因素，关于哪些患者需要摘除，仍然存在重大争议，VH的程度各不相同。这样的眼睛需要仔细评估，适当的辅助治疗可以改善这些患者的预后。
