the International Classification for Intraocular Retinoblastoma (ICIRB)

Last reviewed 01/2018

the International Classification for Intraocular Retinoblastoma (ICIRB)

ICIRB is used to predict the prognosis of patients treated with chemotherapy and focal laser treatment (1).

• Group A: small intraretinal tumours away from foveola and disc.
• all tumours are 3 mm or smaller in greatest dimension, confined to the retina and
• all tumours are located further than 3 mm from the foveola and 1.5 mm from the optic disc
  
  
• Group B: all remaining discrete tumors confined to the retina.
• all other tumours confined to the retina not in group A.
• tumour-associated subretinal fluid less than 3 mm from the tumour with no subretinal seeding
  
  
• Group C: discrete local disease with minimal subretinal or vitreous seeding
  
• tumour(s) are discrete.
• subretinal fluid, present or past, without seeding involving up to one-fourth of the retina.
• local fine vitreous seeding may be present close to discrete tumour.
• local subretinal seeding less than 3 mm (2 DD) from the tumour
  
  
• Group D: diffuse disease with significant vitreous or subretinal seeding
  
• Tumour may be massive or diffuse.
• subretinal fluid present or past without seeding, involving up to total retinal detachment.
• diffuse or massive vitreous disease may include “greasy” seeds or avascular tumour masses.
• diffuse subretinal seeding may include subretinal plaques or tumour nodules
  
  
•  Group E: presence of any one or more of the following poor prognosis features.
• tumour touching the lens.
• tumour anterior to anterior vitreous face involving ciliary body or anterior segment.
• diffuse infiltrating retinoblastoma.
• neovascular glaucoma.
• opaque media from hemorrhage.
• tumour necrosis with aseptic orbital cellulites.
• phthisis bulbi.

Reference:

• (1) Dimaras H et al. Retinoblastoma. Lancet. 2012;379(9824):1436-46