Fine needle aspiration biopsy (FNAB) for retinoblastoma

Purpose: To determine the incidence of diagnostic fine needle aspiration biopsy (FNAB) in eyes with retinoblastoma (RB) as well as its indications and potential complications. Methods: A retrospective study by survey was designed and a questionnaire inquiring on FNAB use in RB diagnosis during the past 15 years was submitted to 12 high-volume ocular oncology clinics. Results: A total of 3,651 patients with RB have been diagnosed and treated in 12 clinics since 1985. During the same period, eight biopsies were obtained for diagnostic purposes and six of these proved to be RB by cytology; the other two showed inflammatory cells and benign retinal cells. The median age for the biopsied patients was 46 months; 6 of the biopsied children were older than 4 years of age. The average age at the time of biopsy was 46 months. Most of the cases were biopsied with clinical diagnosis of uveitis/endophthalmitis through the limbus and pars plana with 25- and 27-gauge needles. Five of six cases of RB had enucleation and one patient had cryotherapy and I-125 brachytherapy after FNAB. The average follow-up time for biopsy-proven RB cases was 10.8 years with no recurrent disease. Conclusion: The results of this survey suggest that FNAB indication for RB diagnosis is rare; the majority of cases can be diagnosed and treated by ocular oncologists without invasive procedures.