Group

Description

Prognosis

A

Small tumors located away from the foveola or optic disc.

Tumor ≤ 3 mm in basal dimension or thickness.

Very low risk

B

Retinal tumors of any size or location not in group A without vitreous or subretinal seeding.

Tumor < 3 mm in basal dimension or thickness or any of the following:

1) Macular location ≤ 3 mm to foveola;

2) Juxtapupillary location ≤ 1.5 mm to disc;

3) Clear subretinal fluid ≤ 3 mm from margin.

Low risk

C

Retinal tumors of any size and location with focal vitreous or subretinal seeding.

One of the following:

1) Subretinal seeds ≤ 3 mm from tumor;

2) Vitreous seeds ≤ 3 mm from tumor;

3) Both subretinal and Vitreous seeds ≤ 3 mm from tumor;

4) Less than one quadrant of subretinal fluid in the fundus.

Moderate risk

D

Massive tumor and/or diffuse vitreous or subretinal seeding

One of the following:

1) Subretinal seeds > 3 mm from tumor;

2) Vitreous seeds > 3 mm from tumor;

3) Both subretinal and vitreous seeds > 3 mm from tumor;

4) Greater than one quadrant of subretinal fluid in the fundus.

High risk

E

Tumor has destroyed the eye anatomically or functionally

Extensive retinoblastoma or one of the following:

1) Irreversible neovascular glaucoma;

2) Massive intraocular hemorrhage;

3) Invasion of post laminar optic nerve, choroid (>2 mm), sclera, orbit, anterior chamber;

4) Tumor anterior to the anterior vitreous face;

5) Diffuse infiltrating tumor;

6) Phthisis bulbi or pre phthisis;

7) Aseptic orbital cellulitis.

Very unfavorable