Opthamology Essays Flashcards
(16 cards)
- What is Retinoblastoma?
🔹 A malignant tumor of the retina occurring in early childhood due to abnormal proliferation of neural cells.
- What is the incidence of Retinoblastoma?
🔹 Affects 1 in 20,000 live births.
🔹 Common in children aged 2-4 years.
- What is the inheritance pattern of Retinoblastoma?
🔹 Autosomal dominant inheritance in 6% of cases. 🔹 Most cases are sporadic mutations.
🔹 Linked to chromosome 13q14 deletion.
- What are the two types of Retinoblastoma based on growth pattern?
🔹 Glioma Exophytum – Grows outward, mimics retinal detachment.
🔹 Glioma Endophytum – Grows inward, extends into vitreous cavity.
- What are the histopathological features of Retinoblastoma?
🔹 Poorly Differentiated Cells: Small round cells with hyperchromatic nuclei. 🔹 Well-Differentiated Cells: Arranged in rosettes and fleurettes.
- What are the types of Rosettes found in Retinoblastoma?
🔹 Flexner-Wintersteiner Rosettes – Specific for Retinoblastoma. 🔹 Homer Wright Rosettes – Also found in neuroblastoma.
🔹 Pseudorosettes – Tumor cells cluster around blood vessels.
- What is Leucocoria?
🔹 Yellow-white pupillary reflex (Cat’s Eye Reflex), most common symptom.
- What are the clinical features of Retinoblastoma?
✅ Leucocoria (Cat’s Eye Reflex) – Most common sign.
✅ Convergent Squint (Esotropia) – Second most common. ✅ Nystagmus – Seen in bilateral cases.
✅ Pain & Proptosis – Due to raised intraocular pressure
- What are the four stages of Retinoblastoma?
1️⃣ Quiescent Stage – Tumor is small, asymptomatic.
2️⃣ Glaucomatous Stage – Increased intraocular pressure, pain, proptosis.
3️⃣ Extraocular Extension – Tumor spreads outside the eye.
4️⃣ Metastatic Stage – Spreads via lymphatics, direct extension, bloodstream.
- What are the three routes of metastasis in Retinoblastoma?
🔹 Lymphatic spread – Preauricular & cervical lymph nodes. 🔹 Direct extension – Optic nerve, brain, cranial bones.
🔹 Hematogenous spread – Bone, liver, lungs.
- What are the differential diagnoses of Retinoblastoma?
🔹 Congenital Cataract
🔹 Pseudoglioma – Due to inflammation (toxoplasmosis, TB, toxocariasis). 🔹 Retrolental Fibroplasia – Seen in premature babies.
🔹 Coats Disease, Choroidal Coloboma, Retinal Dysplasia.
- How is Retinoblastoma diagnosed?
✅ Fundus Examination – Shows tumor masses.
✅ Ultrasonography, CT, MRI – Confirms size & location.
✅ X-ray Orbit – Detects calcification in 75% of cases.
✅ Lactic Dehydrogenase (LDH) in Aqueous Humor – Elevated.
- What is the primary treatment for Retinoblastoma?
🔹 Enucleation – Removal of the eye in Stage 1 & 2.
🔹 Exenteration – Removal of orbit in Stage 3 (extraocular spread).
🔹 Radiation Therapy – Brachytherapy (I-125 plaque), cobalt disc therapy. 🔹 Chemotherapy – Vincristine, Cyclophosphamide, Adriamycin.
🔹 Cryotherapy & Laser Photocoagulation – For small tumors.
- What is the prognosis of Retinoblastoma?
✅ Good if treated early (before extraocular spread).
❌ Poor if optic nerve is involved or metastasis occurs.
🔹 Spontaneous regression is rare but possible due to immune response.
D. List any 3 other clinical signs that children with this diagnosis can present with
- Strabismus (squint)
- Nystagmus
- Vitreous opacity
- Pseudohypopyon
- Spontaneous hyphema
- Iris heterochromia
- Inflammation mimicking orbital cellulitis
- Vitreous hemorrhage
- Glaucoma
- Corneal edema
C. List 5 most likely differentials of leucocoria
: 1. Persistent hyperplastic primary vitreous
2. Coats’ disease
3. Toxocariasis
4. Retinopathy of prematurity
5. Coloboma of the choroid
6. Congenital cataracts
7. Vitreous hemorrhage
8. Retinal detachment
9. Retinal dysplasia
10. Endophthalmitis
