Objective To evaluate the influence of histopathological invasion on the survival prognosis of patients with unilateral retinoblastoma. Methods Seventyseven patients with unilateral retinoblastoma who were treated by primary enucleation were followed up after treatment. The patients were followed up for a median period of 49 months (range from 1 week to 89 months). The survival data were collected by follow-up appointment, telephone or letter. The Kaplan-Meier method was used to calculate the cumulative survival rate and curve comparison was done with the log-rank test including the degree of the optic nerve invasion, choroidal invasion, choroidal invasion with or without optic nerve invasion, as well as the anterior segment involvement or not. Results The two years survival rate was 88.31%. The survival rate of the group with tumor involvement in the cut end of optic nerve was 16.67%, and significantly lower than other groups with optic nerve involvement (chi;2=19.51, 18.42, 18.42, 14.39; P=0.000 0).The survival rate of the group with massive choroidal invasion and scleral involvement was 60.00% and significantly lower than the group without choroidal involvement (chi;2=7.69,P=0.005 5). The survival rate of the group with optic nerve involvement and massive choroidal invasion was 75.00%, and the survival rate of the group with optic nerve involvement and scleral or orbital invasion was 60.00%. The survival rate of those two groups were significantly lower respectively than the group only with optic nerve invasion(chi;2=4.25, P=0.039 3;chi;2=7.59, P=0.005 9).There was no significant difference of survival rate between groups with or without anterior segments involvement (chi;2=0.05,P=0.823 5).Conclusions The risk factors for RB death include the surgical marginal involvement of optic nerve, massive choroidal invasion combined with optic nerve and scleral involvement. The anterior segment involvement has no effect on prognosis of patients with unilateral retinoblastoma.
Objective To observe the toxic effects of intravitreal injection of etoposide on retinal ganglion cells (RGC) in rabbit eyes. Methods Twenty-four healthy rabbits were divided into 8 groups randomly, including one normal group without any treatment, and 7 experimental groups with intravitreal injection of different dosages of etoposide (0.0, 1.5, 15.0, 150.0, 375.0, 750.0, 1500.0 mu;g).Twelve days after the injection, the animals were killed by air embolism, and the eyeballs were prepared for routine pathological examination with hematoxylineosin staining and transmission electron microscopy. Results Four experimental groups (0.0, 1.5, 15.0, 150.0 mu;g etoposide) had normal retinal structure and normal shape of ganglion cells while other 3 experimental groups with higher dosage of etoposide (375.0, 750.0 and 1500.0 mu;g) showed thinner and disorganized retina. The number of RGC of the normal group and 0.0, 1.5, 15.0, 150.0, 375.0, 750.0, 1500.0 mu;ggroups were 61.66plusmn;3.72, 61.83plusmn;4.59, 60.00plusmn;7.07, 62.00plusmn;4.43, 62.67plusmn;3.98, 7.33plusmn;1.37, 0.00 and 0.00 per 400times;visual field, with statistical difference among groups (F=145.04,P=0.00). There was no statistical difference between the normal group and 0.0, 1.5, 15.0, 150.0 mu;g groups (F=0.244,P>0.05). The number of RGC of 375.0 mu;g group was decreased obviously compared with normal group and 0.0, 1.5, 15.0, 150.0 mu;g groups with statistical difference(F=145.04,P<0.05). Conclusion Etoposide has a dosage-dependent toxicity on rabbit RGCs.
Objective To evaluate the role of the cell cycle related genes cyclinD1 and Bcl-2 protein expression in the pathogenesis and infilt ration of the uveal melanoma. Methods Using immunohis tochemistry to detect the cyclinD1 and bcl-2 protein expression in 96 cases of uveal melanoma. Results The expression content of bcl-2 was high in uveal melanoma, and there wasn't any relationship between bcl-2 cell positivity and tumor cell type and extrascleral extension. In contrast, cyclinD1 expression was higher in epithelial cell uveal melanoma than mix cell and spindle cell varieties. There was a positive correlation between cyclinD1 cell positivity and extrascleral extension. Conclusion The expression of bcl-2 protein is important for the survival of the uveal melanoma. CyclinD1 may serve as a sensitive index of its malignancy. (Chin J Ocul Fundus Dis, 2001,17:44-46)