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To the Editor.
—I appreciate the notice Mr. Suckling took of the editorial by Dr. Spencer and myself in the Archives. His study, "An Epidemiologic Study of Retinoblastoma in New Zealand," gives strong indication that in his country there is no clustering in time or space of cases of retinoblastoma. His findings, however, do not seem to me to substantiate his conclusion that "... retinoblastoma has a relatively well-defined genetic cause...." While there is undoubtedly a genetic role in retinoblastoma, I would take issue with his assumption that the gene is the cause. As Dr. Zimmerman pointed out in his paper, "Changing Concepts Concerning the Pathogenesis of Infectious Diseases," to which Mr. Suckling refers, there are many reasons for doubting that the presence of a gene alone causes the tumor. It seems to me more likely that the gene predisposes the retina to some other oncogenic factor in the environment.If
Albert DM. An Epidemiologic Study of Retinoblastoma in New Zealand-Reply. Arch Ophthalmol. 1975;93(1):87. doi:10.1001/archopht.1975.01010020091018