Group | Summary | Sub-Group | Specific Features | Usual Treatment |
A | Small Tumor | | Tumor ≤ 3mm (in greatest dimensions) | Focal Laser or Cryotherapy |
B | Large Tumor / Poor location | | Tumor >3mm or macular retinoblastoma location (≤3 mm to foveola) juxtapapillary retinoblastoma location (≤1.5 mm to disc) additional subretinal fluid (≤3 mm from margin) | Chemoreduction, Plaque therapy |
C | Focal seeds | C1 | Subretinal Seeds ≤ 3 mm from tumor | Chemoreduction, Plaque therapy |
C2 | Vitreous Seeds ≤ 3 mm from tumor |
C3 | Both Subretinal and vitreous seeds ≤ 3mm from tumor |
D | Diffuse Seeds | D1 | Subretinal seeds >3 mm from tumor | Chemoreduction IV or IAC, enucleation (unilateral) |
D2 | Vitreous seeds >3 mm from tumor |
D3 | Both subretinal and vitreous seeds > 3 mm from tumor |
E | Extensive retinoblastoma | | Extensive tumor occupying >50% globe or neovascular glaucoma, opaque media from hemorrhage in anterior chamber, vitreous or subretinal space invasion of postlaminar optic nerve, choroid (>2 mm), sclera, orbit, anterior chamber | Enucleation |