The Reese-Ellsworth classification for retinoblastoma has largely been replaced by the International Classification of Retinoblastoma (ICRB/IIRC). In the ICRB, Group E eyes are characterized by:

• A Discrete tumors up to 3 disc diameters at or behind the equator
• B Any tumor with seeding limited to the vitreous
• C Tumors with subretinal seeds without vitreous involvement
• D Eyes with irreversible structural damage and no potential for useful vision, including neovascular glaucoma, hyphema, or tumor in the anterior chamber ✓

Explanation

ICRB Group E represents the most severe intraocular disease — eyes that have essentially no chance of useful vision due to extensive tumor (>50% of globe), neovascular glaucoma, opaque media, hyphema from tumor neovascularization, or orbital cellulitis. These eyes usually require primary enucleation. The classification guides chemotherapy planning and helps predict which eyes can be salvaged with intra-arterial chemotherapy versus those requiring surgery.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.