There is no international classification of retinoblastoma that can satisfactorily address the need to aid in the diagnosis, therapy and the prognosis, both visual and systemic, of our retinoblastoma patients. The Reese-Ellsworth Classification, adopted in the 1950s is still the one being followed today. Its usefulness is limited to visual and systemic prognosis especially with the use of External Beam Radiation (EBR) and nitrogen mustard chemotherapy which were the only means of therapy available at those times. The Essen Classification, which was introduced later, provided only additional ocular findings that just addressed mainly the visual and systemic prognosis This modified classification is proposed to precisely meet the need of the general ophthalmologist to diagnose the tumor, get guidelines in its therapy, and have an idea of its visual and systemic prognosis. This is based on new knowledge gained about the tumor and advances in technology, which have resulted in more efficient diagnostic equipment and newer modes of therapy. The added years of follow-up also makes prognostication more reliable Hopefully also, if it is ever adopted internationally, it can make research studies done worldwide more comparable.
Human ; Aged ; Middle Aged ; Adult ; RETINOBLASTOMA ; GENES, RETINOBLASTOMA

Human ; Middle Aged ; Adult ; RETINOBLASTOMA ; GENES, RETINOBLASTOMA ; EYE CANCER, RETINOBLASTOMA ; FAMILIAL RETINOBLASTOMA ; GLIOMA, RETINAL

Objective: To characterize diabetic maculopathy seen in the Philippines, specifically, the associated factors, the various lesions seen on fluorescein angiography, and the visual acuity associated with these lesions Design: Descriptive study - cross sectional Participants: 127 patients (254 eyes) with diabetic retinopathy based on the fluorescein angiography done at the Eye Referral Center in 1993 Results: 116 (91.34 percent) patients have maculopathy, majority of which is bilateral (84.25 percent). Age (p=0.675), sex (p=0.357), hypertension (p=0.742), duration of diabetes (p=0.778) and myopia (p=0.742) were not significantly associated with maculopathy. However, severity of retinopathy (p=0.001) was significantly associated with it. Fluorescein angiographic findings are macular staining (83.86 percent), perifoveal capillary dropout or macular ischemia (10.76 percent), and preretinal traction and membrane (5.38 percent). Microaneurysm (72.65 percent) is the most common lesion associated with macular staining, followed by capillary leakage (4.04 percent), cystoid macular edema (3.59 percent), perifoveal capillary dropout with microaneursym (2.24 percent), and capillary with microaneursym leakage (1.34 percent). Exudates are associated with microaneurysm, perifoveal capillary dropout or their combination. Vision was found to be marginally statistically different between the normal and maculopathy group (p=0.0505). The worst vision was seen in macular ischemia and preretinal traction and membrane with mean visual acuity of 0.18 and 0.25 respectively Conclusion: Severity of the retinopathy is the only variable significantly associated with maculopathy in this study. Good vision does not necessarily indicate a normal macula. Detailed examination and fluorescein angiography regardless of duration of diabetes should be done.
Human ; Middle Aged ; Adult ; ANGIOGRAPHY ; DIABETIC RETINOPATHY ; RETINA,DISEASES

Objective: This study correlated the patterns of ocular B- and A-scans of intraocular retinoblastoma (RB) with corresponding histopathology sections. It aimed to establish a more objective basis for determining intraocular retinoblastoma by ultrasonography (UTZ) and to determine the degree of malignancy and viability of the tumor cells. Methods: New cases of retinoblastoma seen at the University of the Philippines-Philippine General Hospital (UP-PGH) from January 1994 to December 2003 were reviewed. Included were patients who underwent enucleation and whose eyeballs were processed at the UP Institute of Ophthalmology. Those with good quality ocular ultrasonographs (UTZ) and clear matching histopathologic sections were finally selected. Findings were correlated and analyzed.Results: Retinoblastoma (RB) showed multiplicity of lesions on UTZ corresponding to multiple lesions on histopathology. The following characteristic patterns were seen: Very malignant RB or pseudorosettes: fine, grainy densities on B-scan with short to medium broad spikes on A-scan ("V-W" pattern). Moderate differentiation with moderate necrosis and early calcific plaques: fine, dense grainy opacities on B-scan with multiple thin, high spikes admixed with tall, broad spikes of calcium deposits on A-scan. Well-differentiated RB with compact viable cells and no necrosis: large, white densities on B-scan with an initial high spike and high internal reflectivity, sometimes "plateauing," on A-scan with no calcific deposits. Complete tumor necrosis with calcific plaques: echolucent space with dense, white, plaque-like opacities on B-scan; flat or low spikes mixed with tall, broad spikes corresponding to calcium plaques on A-scan. Normal vitreous, serous subretinal fluid, or recent hemorrhage: echolucent area on B-scan with flat or low spikes on A-scan. Conclusion: The three most frequent findings in intraocular retinoblastoma were calcific plaques with liquefaction necrosis, multiplicity of lesions, and pseudorosettes. Ocular ultrasound of retinoblastoma showed good histopathologic correlation.
Human ; RETINOBLASTOMA ; ULTRASONOGRAPHY ; RETINAL NEOPLASMS ; RETINAL DISEASES ; EYE DISEASES ; PATHOLOGY

Methods: This is a retrospective case series of new retinoblastoma patients seen at the University of the Philippines-Philippine General Hospital (UP-PGH) in three periods: 1967 to 1977, 1985 to 1995, and 1997 to 2001. The demographic and clinical characteristics of retinoblastoma over the three periods were compared. Results: The incidence of retinoblastoma increased from 40/100,000 new cases in 1967 to 1977 to 237/100,000 new cases in 1997 to 2001. The average age at onset did not change over time but the age at consultation decreased from 1.5 years to 1 year. The most common initial ocular manifestation at onset was cats eye reflex (77 to 79 percent) with findings of leukocoria (67 to 77 percent). Extraocular findings of proptosis and orbital mass declined through the years. Bilateral retinoblastoma comprised 30 percent in this series and showed no change in distribution over the years. Conclusion: The epidemiological and clinical patterns of retinoblastoma cases at the Philippine General Hospital may be changing over time and requires continuous monitoring of incidence and characteristics.
Human ; Male ; Female ; Infant ; RETINOBLASTOMA

A five-year review of anorectal complications seen following radiotherapy for cervical carcinoma was done with the following objectives: 1) to present the profile of patients presenting with anorectal complications following radiation treatment for cervical cancer; 2) to describe the manifestations of these complications and findings on proctosigmoidoscopy with biopsy; and 3) to present the approaches in their management. A total of 116 patients, all with confirmed diagnosis of cervical cancer, were seen over this period. Mean age was 49.5 years. All received external beam cobalt and intracavitary radium. Complications were observed from 10 days to 20 months after treatment. Anal bleeding was the most common complaint (62%), followed by rectovaginal fistula (14%). Residual/recurrent malignancy was noted in seven patients (6%). Treatment modalities varied considerably, ranging from conservative and symptomatic treatment for bleeding, pain, constipation, and diarrhea, to major abdominal procedures for rectovaginal fistula

Human ; Rectovaginal Fistula ; Constipation ; Sigmoidoscopy ; Uterine Cervical Neoplasms ; Cobalt ; Pain ; Biopsy ; Diarrhea ; Anus Diseases