High-risk features in retinoblastoma: the association between histopathology and MRI.

Cohort studyBMJ open ophthalmology· Oct 2025

High-risk features in retinoblastoma: the association between histopathology and MRI.

Wajiha J Kheir, Roula Hourani, Youssef Zougheib … Christiane Al-Haddad

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Ocular OncologyCohort studyDiagnosisQ1IF 2.8

MRI has high false-positive rate for postlaminar optic nerve invasion in retinoblastoma

High-risk features in retinoblastoma: the association between histopathology and MRI.

Wajiha J Kheir … Christiane Al-Haddad

BMJ open ophthalmology · Oct 2025 · Q1 in Ophthalmology

Background

Identification of high-risk features is essential for improving treatment outcomes of retinoblastoma.

Purpose

This study aims to evaluate high-risk features in retinoblastoma by comparing MRI with histopathology results.

Methods

This was a retrospective chart review of patients enrolled in the retinoblastoma programme at the American University of Beirut Medical Center from November 2012 to December 2022.

n = 48 eyes

Results

MRI flags on postlaminar invasion were wrong most of the time

66.7%

Sensitivity

71.1%

Specificity

96.9%

NPV

13.3%

PPV

More results

Males constituted 52.1% (n=25) of the sample and females 47.9% (n=23).

58% had unilateral retinoblastoma.

The median age at diagnosis was 14.5 months (10-34.5).

MRI showed high accuracy in detecting invasion of the anterior chamber (79.2%) and moderate accuracy in detecting invasion of the sclera (62.5%).

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Conclusion · 1 of 2

MRI showed high levels of variability in detecting high-risk features in advanced retinoblastoma. MRI results ought to be interpreted with caution when making treatment decisions in advanced retinoblastoma.

Conclusion · 2 of 2

Limitations of our study included a relatively small sample size, retrospective design and possible technical constraints of MRI imaging.

High-risk features in retinoblastoma: the association between histopathology and MRI.

High-risk features in retinoblastoma: the association between histopathology and MRI.

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