Bilateral Conversion Risk in Unilateral Retinoblastoma Using Age and Genetic Testing

Can age at diagnosis and genetic subtype predict metachronous bilateral conversion in initially unilateral retinoblastoma?In this cohort study including 1108 patients, 24 developed metachronous bilateral disease, and genetic testing in 316 patients identified 62 variant–positive and 254 variant–negative cases. All 15 -positive converters were diagnosed at the index presentation before age 9 months, whereas all 4 variant-negative converters were initially diagnosed after age 20 months.The findings suggest that age at diagnosis may stratify bilateral conversion risk: variant–positive patients diagnosed at 9 months or older represented a very low-risk subgroup warranting deescalated surveillance.

Corresponding Authors: Peiquan Zhao, MD, PhD (zhaopeiquan@xinhuamed.com.cn), and Tingyi Liang, MD (liangtingyi@xinhuamed.com.cn), Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai 200092, China.

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