Orbital CT scan, orbital MRI, eye ultrasound and fundus examinations were performed in all patients. In addition, neuron specific enolase (NSE) in serum and cerebrospinal fluid (CSF) of patients were analyzed using the electrochemiluminescence with the NSE Kit (Roche, US). Lactate dehydrogenase (LDH), a non-specific tumor marker, was detected by chemical immunoassay. The pathology examination of CSF was performed by hematoxylin eosin staining. In our hospital, all patients whose imaging or serology test showed RB were also undergoing bone marrow aspiration. If bone marrow involvement was confirmed, re-examination should be conducted every 3 months until complete remission of bone marrow.

Diagnosis of retinoblastoma was usually clear from presenting signs and clinical examination [10]. MRI was used to assess invasion of the optic nerve. All tumors were classified (stage 0-IV) according to the International Retinoblastoma Staging System (IRSS) proposed by Chantada et al. [11].

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