The international classification of retinoblastoma (IIRC/LIRB classification) — Group E disease includes eyes with:

• A Tumor > 3 mm, macular or juxtapapillary location, subretinal fluid < 3 mm from base
• B Diffuse subretinal seeding, subretinal seeds > 3 mm from the margin of any discrete tumor, or vitreous seeding
• C Any of: neovascular glaucoma, opaque media from hemorrhage, tumor anterior to anterior vitreous face, or diffuse infiltrating retinoblastoma ✓
• D Discrete tumor < 3 mm, no subretinal fluid, no vitreous seeding

Explanation

The International Intraocular Retinoblastoma Classification (IIRC) groups A through E, with Group E being the most advanced. Group E includes eyes with any of: neovascular glaucoma, massive tumor (> 2/3 globe volume), opaque media from hemorrhage or tumor seeding, invasion anterior to anterior vitreous face, diffuse infiltrating retinoblastoma pattern, or phthisis bulbi. Eyes in Group E have poor salvageability and enucleation is often the treatment of choice, as systemic chemotherapy and focal therapies are unlikely to preserve useful vision. Group D represents less severe vitreous/subretinal seeding. Groups A-C have increasingly good salvage rates with chemotherapy and focal treatment.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.