A review of 426 patients with retinoblastoma(RB)who presented to Eye Hospital of Zhongshan Ophthalmic Center from 1966 to 1991 showed that 81(19.01%)patients were more than or equal to 5 years of age(median age 6.95 years)at the time of initial diagnosis.All patients are unilateral except 4 cases who are bilateral.The main presentations included leukocoria,exophthalmos,congertion and pain of the eye,drcreased vision,strabismus,oculare hypertension,vitreous opacity,hypopyon and hyphema,etc.Some atypical presentations in these older patients with RB were discussed and some problems that should be noticed in the diagnosis and management were presented.discussed and some problems that should be noticed in the diagnosis and management were presented.
（Chin J Ocul Fundus Dis,1993,9:205-206）
The studies of immunohistochemistry, histochemisu3r and electron microscopy in 50 patients with retinoblastoma were carried out. Our results show that retinoblastoma origin from primitive retinal neuronal cells that can differentiate into nmture neuron (including retinal photoreeeptor) and glial cells.The glial component in the retinoblastoma is mainly reactive glial proliferation.There is a good prognosis in the patients with retinoblastoma in which there are a lot of differiation areas and glial proliferation.
（Chin J Ocul Fundus Dis,1993,9:193-197）
OBJECTIVE：Observing the clinical and pathological features of Coats disease. METHODS:Reviewing the clinical data and pathologic slides duly confirmed by pathology of 19 cases of Coats disease,which belonging to our college's Laboratory of Ophthalmologic Pathology from 1959 to 1994.
RESULTS: 14 males,5 females,aged 1-18 years. More boys were affected than girls in the age group under 10 and that difference between both sexes became gradually less as they grew older. The main pathologic changes were the vascular dilatation and congestion of the outer layer of the retina,the uneven thickness of the vascular walls and the proliferation of the connective tissue. Retinal protuberance was seen in most of the advanced cases.with bleeding and vascular changes on its surfaces. The main pathologic changes were the detachment of retina and the appearance of many foam cells and crystals of cholesterol in the subretnal fluid,and calcification and ossification of the outer layer of the retina were found in some cases.
CONCLUSION :Cytological examination of the subretinal fluid might be the liable method in differentiating between the Coats disease and retinoblatstoma.
（Chin J Ocul Fundus Dis,1996,12: 157-159）
Children with retinoblastoma (RB) typically survive their cancer due to advances in early diagnosis and treatment. Extraocular invasion and metastasis, and secondary malignant tumor carry a very high mortality rate. Prerequisites for metastasis include tumor initiating capacity, altered cellular adhesion and cell motility, resistance to extracellular death signals and disruption of the basement membrane and extracellular matrix. All those changes can be determined by the cell of origin and the genetic instability of the tumor, responding to the multiple layers of pressure such as hypoxia, from the tumor microenvironment or niche. The interaction between tumor cells and the tumor stroma is regulated by several metastasissuppressor proteins and microRNA. This knowledge has important implications for our understanding and the treatment of extraocular spreading of RB.
Objective：To observe the therapeutic ef fect of chemoreduction treatm ent combined with local focal therapy for advanced intraocular retinoblastoma (R B).
Methods：Thirteen eyes of nine patients with RB underwent c hemoreduction tr eatment combined with local cryotherapy and (or) transpupillary thermotherapy (TTT), and the clinical data of the patients were retrospectively analyzed. The vi ncristine, etoposide, and carboplatin (VEC) were used in the chemoreduction trea tment. The average followup duration was 15.3 months.
Results：All of the 13 e yes with RB had favorable initial reaction in the treatment of chemoreduction. A fter the first period of chemotherapy, the largest diameter of the tumor fundus decreased 37.2%, and the tumor thickness averagely reduced 46.7%. The subretinal fluid was absorbed completely or partially in 6 eyes (6/8); vitreous and subret inal seeds reduced, disappeared or calcified in 10 (10/11) and 11 eyes (11/11), respectively. During the treatment and in the followup duration, 8 eyes (8/13) had new tumors and (or) recurrences. Finally, 2 eyes (2/13) were enucleated whil e 11 eyes (11/13) were saved in which 8 (8/11) recovered or remained good visual acuity. None of 9 patients had serious side effects of chemotherapy like leucoc ythemia, functional damage of liver and kidney, and dysacousia.
Conclus ions：Chem oreduction treatment has well initial effect on advanced RB. Chemoreduction trea tment combined with local treatment may effectively control the retinal tumor, s ubretinal seeds and vitreous seeds within a shortterm duration. The evaluation of longterm effect of the treatment needs further observation.
Objective To investigate inhibited effects of melatonin (MLT) on proliferative activity of retinoblastoma cell line HXORB44 and its related mechanism. Methods HXO-RB44 cells were treated by MLT of different concentration (10-10, 10-9, 10-8, 10-7 mmol/L. Cell counting and tetrazolium dyereduction assay (MTT) were used to determine the effect of MLT on the survival and proliferation of HXO-RB44 cells. Apoptotic nuclei were further analyzed by HoechstPI fluorescence staining. Flow cytometry was used to measure the fluorescent intensity of ROS, cell cycle distribution and apoptosis. Results 10 -6 mmol/L (or exceed) of MLT could inhibit the proliferation of HXO-RB44cells in vitro while 10-7 mmol/L (or below) of MLT couldn't. With the increase of MLT concentration from 10-10 mmol/L to 10-7 mmol/L, HXO-RB44 cells gradually increased the expression of ROS. Hoechst staining showed that 4, 8, 12 and 24 hours after the incubation with MLT, the nuclear pyknosis and nuclear fragmentation increased in HXORB44 cells. The extent of apoptosis was proportional to the concentrations of MLT. Flow cytometry revealed that with the increasing of MLT concentration, G0/G1 and G2/M phase cells increased, S phase cells decreased. The apoptotic rate was also increased. Conclusion 10 -6 M of MLT could inhibit the proliferation of HXO-RB44 cells. This effect may relate to the increased ROS expression, cell cycle arrest at G0/G1 phase and apoptosis of HXO-RB44 cells.
ObjectiveTo explore the presence of common genetic alterations in retinoblastoma and to localize the altered genomic regions.MethodsGenetic instability of chromosome 19, 20, 21, 22 and X of 15 microdissected retinoblastoma tumors were analyzed by the loss of heterozygosity (LOH) and microsatellite instability (MSI).ResultsAmong the 15 patients with retinoblastoma, genome instability ［LOH and(or) MSI］ at one or more loci on the 5 chromosomes in 10 (67%), in which the loss of a single allele was more frequent in chromosomes 19 (33%) and 20 (27%) than in the other 3 chromosomes. Highfrequency LOH between D19S902 and D19S571 suggested gene loci in the 19q13 region might be associated with tumor development in retina. According to the result of MSI, MSI occured at least in one subset of retinoblastoma.ConclusionsOur results provide first evidence of LOH in chromosomes 19 and 20 in retinoblastoma and further support the presence of genome instability in retinoblastoma that may play an important role in the tumorigenesis or progression of retinoblastoma.(Chin J Ocul Fundus Dis, 2005,21:28-31)
Intraocular tumors is a serious blinding eye disease, which has a serious impact on patients' vision and even life. At present, the main treatments include surgical treatment, radiation therapy, chemotherapy, laser therapy and combination therapy. In recent years, with the wide application of anti-vascular endothelial growth factor (VEGF) in the treatment of ocular diseases, many studies have confirmed that anti-VEGF drugs play an important auxiliary role in the treatment of intraocular tumors and its complications. In terms of the therapeutic effect, intravitreal anti-VEGF combined with other methods have a good prognosis in the treatment of choroidal metastatic carcinoma and retinoblastoma, while the therapeutic effect of uveal melanoma is still controversial. In the treatment of intraocular tumor complications, intravitreal anti-VEGF also has a good effect on the secondary lesions of choroidal osteoma and radiation retinopathy. As for drug safety, intravitreal anti-VEGF can significantly reduce the toxic and side effects of systemic chemotherapeutic therapy. However, the dosage and medication regimen of anti-VEGF drugs in the treatment of intraocular tumors and their complications have not been unified in current studies, and further basic and clinical trials are still needed to explore in the future.
Silver staining technique and computer-assisted image analysis system were used in this study to detect,compare and analyse the nuclear organizer regions(NORs)in human normal retina and retinoblastoma(including differentiated and non-differentiated).The results showed that the mean number of AgNOR per nucleus,the average silver staining area per nucleus and retino of silver staining area to nuclear area in non-differentiated retinoblastoma were much higher than that in differentiated retinoblastoma and normal retina.This might suggest that AgNORs technique and computer-assisted image analysis system have important role in the typing,grading and expectation of progression of retinoblastoma.
（Chin J Ocul Fundus Dis,1993,9:202-204）
ObjectiveTo observe the curative effect, survival rate, enucleation rate and pathological characteristics of retinoblastoma (RB) in children.MethodsRetrospective clinical study. From March 1999 to December 2018, a total of 313 patients (445 eyes) with RB diagnosed in Ophthalmology Department of Peking University People’s Hospital were enrolled in the study. Among them, 175 were male (55.9%), 138 were female (44.1%); 181 were monocular and 132 were binocular. The international standard of intraocular RB staging (IIRC) was 6, 13, 6, 52, 227 and 9 patients of A, B, C, D, E and extraocular stages respectively. Among the 313 patients, 245 patients were confirmed to the survivance, of which 22 cases (9.0%, 22/245) died. Among 445 eyes, 330 eyes definitely whether or not were enucleated; 184 eyes had definite IIRC stage, eye examination results, definite treatment plan and times before enucleation and definite pathological tumor node metastasis stage after operation. The basic information, demographic characteristics, clinical information, enucleation and treatment plan, pathological and immunohistochemical results were recorded. Binary logistic regression was used to analyze the risk factors of high risk pathological features (HRF) and prognosis in patients with RB.ResultsFrom 1999 to 2018, the survival rate of 245 patients was increased from 82.6% to 96.3% year by year; the enucleation rate of 330 eyes with final enucleation was reduced from 68.8% to 58.3% year by year. The rate of enucleation in stage D and stage E decreased from 83.3% and 100% before 2005 to 37.5% and 85.4% after 2014, respectively. Monocular disease (β=－1.551, P=0.005), stage D, stage E and extraocular stage in IIRC stage (P＜0.005) were the independent risk factors of RB enucleation, while the protective factors were Interventional chemotherapy of ophthalmic artery (IAC) (β=－0.877, P＜0.001). HRF was found in 51 eyes (27.7%). Age of onset (β=0.019, P=0.016) and glaucoma (β=0.816, P=0.050) were independent risk factors for HRF in RB pathology, while IAC treatment was the protective factor for enucleation (β=21.432, P＜0.001).ConclusionsAfter comprehensive treatment, the general trend of RB enucleation rate is gradually decreasing. IAC treatment can reduce the enucleation rate of stage D and E. The older age of onset and glaucoma stage are the independent risk factors of HRF, and IAC can reduce the risk factors of HRF.
