Lu JE, et al. - Authors evaluated the metastases and metastatic deaths in unilateral retinoblastoma in the US. They conducted a retrospective chart review at five tertiary retinoblastoma centers in the US for unilateral retinoblastoma patients treated with primary enucleation, from 2007–2017, with >1 year of follow-up or treatment failure. A low rate of metastatic death resulted from primary enucleation for unilateral retinoblastoma, but it a 3.9% chance of metastases within a year of enucleation was still seen. Higher risk histopathological findings were seen in most, though not all patients who developed metastases. Within 12 months, all metastases were apparent. In 62 of 228 eyes (27%), higher risk pathology (postlaminar optic nerve and/or massive choroidal invasion) was revealed by histopathology.