Retinoblastoma

  • Retinoblastoma is the most common intraocular tumor of childhood.

Clinical Manifestations

  • Leukocoria (60%)
  • Strabismus (20%)

Other - Uveitis, Orbital cellulitis, Hyphaema, Heterochromia, Glaucoma, Bupthalmos

  • Calcification is another feature of retinoblastomas, usually occurring in necrotic areas.
  • Calcium stains with H&E. It is worth identifying calcium in suspect eyes by ultrasound or CT scan to differentiate retinoblastomas from other tumors.

Management

  • Empirical Genetic Counselling

    • Enucleation

      • Unilateral, poor visual prognosis
    • Plaque

      • 4-12mm +/- vitreous seeding
    • External Beam

      • 12mm, multiple foci, only eye

    • Laser

      • Consider - indirect, xenon arc
      • Cryotherapy if <2dd in size
    • Chemotherapy, if intracranial extension