July 16, 2012 Retinoblastoma
Retinoblastoma (glioma) is a tumor of the inside eye’s membrane or the retina.
It occurs in the first years of life, in 30% of cases on both sides. It is inherited AD. It is noticeable only when it affects the vitreous, so from the extended pupillary opening for a blind eye, bursts a yellow reflex, reminiscent of the cat’s eye.
Retinoblastoma is a common malignant intraocular tumor of the childhood age. It should be considered in every child with a white pupil and strabismus. Characteristically, it occurs more than once on the retina at once, and is often calcified, as seen from the roentgen recordings. Retinoblastoma in about 40% of cases runs in family; all bilateral retinoblastoma are hereditary, so the survivors who intend to have children should have an advice of geneticists. Retinoblastoma is very vicious tumor that spreads all around and metastasis hematogenously. Survival depends on early diagnosis. Smaller tumors can be treated with cryotherapy and radiation, and bigger ones require enucleation.
Retinoblastoma in the left eye
Phases of tumor development:
• First phase – white-grey round object on the retina, with clear boundaries, blooded, exophytic growth with retinal ablation or endophytic growth with the proliferation in the vitreous.
• Second phase – increased intraocular pressure and the occurrence of secondary glaucoma, pain, hyperemia, edema, in children also occurs buphtalmus.
• Third phase – the tumor affects the optic nerve, perforates the sclera and expands into orbit
• Fourth phase – the metastatic tumors in the brain, in the meninges and in the visceral organs
Treatment:
Photocoagulation in the early stage, enucleation of the eye with the removal of the optic nerve and eventually exenteration of the orbit with radiotherapy.
Hemangioma of the retina
Hemangioma of the retina is usually congenital, with the presence of similar changes elsewhere in the body – the orbit, brain, facial skin (naevus flammeus), kidneys and elsewhere. It is composed of a tangle of arteries and veins, or of the mass of the capillaries.
Astrocytoma
Astrocytoma is a benign tumor that usually occurs in only one eye (in 15% cases it is bilateral). It occurs as translucent nodule on the optical disk, or close to it. Treatment is usually not necessary.