Pathologic evidence of retinoblastoma seeds supported by field emission scanning electron microscopy and Raman spectroscopy

Abstract

Purpose: The aim of this study was to examine the pathology of retinoblastoma (RB) seeds with supportive evidence by field emission scanning electron microscopy and Raman spectroscopy. Methods: This study was a laboratory-based observational study. Enucleated eyeballs received in the ocular pathology department of a tertiary eye care center in northeast India were included in the cohort after obtaining written informed consent during the surgery. The study was carried out for 6 years (2015–2020). Most of the eyeballs were Group-E RBs. Standard eyeballs sectioning were done by bread loaf techniques. Gross documentations included RB seeds seen in the smallest calotte done with utmost care. Seeds were documented also in permanent sections. Scanning electron microscopy and Raman spectroscopy were carried out in an index case. Results: Out of the total 59 cases, 35 RB cases had different seedings. The mean age at enucleation was 2.9 years. RB seeds were seen in vitreous ( n = 19), subretinal plus vitreous ( n = 7), anterior chamber ( n = 1), over crystalline lens ( n = 3), retinal surface ( n = 1), retinal pigment epithelium (RPE; n = 2), subretinal ( n = 1), calcified seeds ( n = 2). Other characteristics were dusts ( n = 7), clouds ( n = 11), spheres ( n = 4), and unspecified type ( n = 13). Histopathological high-risk factors showed significant choroidal ( n = 22) and optic nerve ( n = 15) involvement. Few cases had extraocular spread. Undifferentiated tumor ( n = 24) was seen with higher evidence of necrosis ( n = 23). Raman spectra differentiated the seeds from the normal tissue on the basis of lipid and protein content. Conclusion: This study highlights the different types of RB seeds with high-risk factors. The morphology of those seeds showed the difference between vitreous and subretinal seeds under advanced microscopic observations.