1 post published by pediatriceducationmin on January 2, There are many causes of leukocoria in children (table 1); the differential diagnosis can be narrowed through a complete clinical and family. Differential Diagnosis of Leukocoria. Jerry A. Shields and Carol L. Shields. ETINOBLASTOMA is a highly malignant. R intraocular tumor of childhood that re-.

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The classification of retinal detachment. Furthermore, children carrying the RB1 gene suffer life-long exposure to other non-ocular primary malignancies, in particular osteosarcoma of the orbit or elsewhere Moll et al; Abramson ; Abramson et al At this stage it forms a dense fibrovascular membrane reaching from front to back of the vitreous body and may cause retraction of arborized vessels to form a falciform fold, papillary dysversion and macular ectopia.

Retinoblastoma is diagnosed in 47 percent of children who are referred with leukocoria to tertiary centers. A thorough clinical examination is pivotal to the diagnosis of leukocoria.

Delay in diagnosis of retinoblastoma: Questions for Further Discussion 1. All positions of gaze should be elicited, first of all in miosis then repeated with the pupil fully dilated, taking advantage of mydriasis to detect any anomaly of the macular or papillary region on ophthalmoscopy. The anterior chamber and lens appeared normal.

Affecting very young infants, in most cases perfectly healthy in all other respects, this highly malignant cancer of the retina threatens those individuals with the longest potential lifespan. A full family anamnesis is essential, with particular attention to any history of enucleation in infancy.

Although he had no obvious physical abnormalities associated with a congenital syndrome, he was referred to genetics for consultation. Uveal coloboma appears as a sharply demarcated, glistening white, bowl-shaped excavation in the fundus Fig. The exudates may be responsible for a luminous leukocoria Figure 3a but, in the presence of retinal detachment, this will take on a greyer hue. Retinoblastoma can present in 3 growth patterns: Whether the leukocoria or any retinal lesion be confirmed at this stage or not, there should be no delay in referring the child to a specialist.


Most Viewed content is not available. The work-up was an immediate consultation with a pediatric ophthalmologist and the diagnosis of unilateral retinal detachment was made.


Angiogenesis starts around the 16th week of gestation and normally terminates at 36 weeks diagnosjs the nasal retina, at term for the temporal retina. Abstract Leukocoria in infants is always a danger signal as retinoblastoma, a malignant retinal tumor, is responsible for half of the cases in this age group.

In all respects, retinoma resembles a retinoblastoma sterilized by radiotherapy, without ever having undergone any treatment whatsoever. This is characterized by homogenous, more or less translucent greyish masses, calcifications, with pigment migration and proliferation bordering the tumor Gallie et al Clinical presentation The clinical presentation of retinoblastoma varies according to the type of growth of the tumor and duration, the degree of vascularization and presence of calcifications, vitreous seeding, retinal detachment or hemorrhage.

Vitreous and subretinal seeding, along with calcifications, are the characteristics virtually pathognomonic of retinoblastoma Figure 2d. Non invasive and well tolerated, it provides invaluable information on the presence of fibrosis, edema or subretinal fluid in the foveal area Shields et al First manifestations usually occur in early childhood, occasionally in the adult, with leukocoria, poor vision and typically a vascularized iris mass, this greyish or salmon-colored, in some cases pigmented.


Clinical variations and complications of Coats disease in cases: Otherwise it is hidden from view.

D/D Of Leukocoria (White reflex in eye) Mnemonics

Sorry, your blog cannot share posts by email. They also denied trauma. The RB1 gene belongs to the group of anti-oncogenes, also called tumor-suppressor genes. The tumor can actually be visualized behind the clear lens. Leukocoria means a white leuko reflex from the pupil coria.

FA with Retcam photography is useful in evaluating children with leukocoria. Endophytic retinoblastoma shows a marked tendency to invasion of the vitreous by seeding.

The rest of his examination was normal. Presenting signs of retinoblastoma. In the long term, enucleation may be inevitable due to terminal glaucoma, intra-ocular hemorrhage, retinal detachment, uveitis or phthisis bulbi.

Differential diagnosis of leukocoria and strabismus, first presenting signs of retinoblastoma.

Thus the importance of keeping in mind the possibility of retinoblastoma differentila confronted with suspicious signs dignosis as a white pupil or leukocoria Figure1athe most common first manifestation, strabismus or any other unexplained signs.

Essential and accurate information about the patients is gathered. A month-old boy was referred by his pediatrician because a whitish reflex from his left pupil Figure was noticed by his parents in certain directions of gaze.

Less frequent manifestations are inflammatory conditions resistant to treatment, hypopyon, orbital cellulitis, hyphema or heterochromia. Second primary tumors in hereditary retinoblastoma: