#37. Tumours of the retina / retinoblastoma

Question 1

What is RETINOBLASTOMA?

Answer 1

• MALIGNANT Tumour of IMMATURE Retinal Cells
• Develops in EARLY Childhood

Question 2

What is the EPIDEMIOLOGY of RETINOBLASTOMA?

Answer 2

• MOST COMMON Malignant tumour IN CHILDREN
• 1 : 20,000 Births
• 30% Cases are BILATERAL

Question 3

What is the PATHOGENESIS of RETINOBLASTOMA?

Answer 3

• SOMATIC Mutation is detected
• AUTOSOMAL DOMINANT Trait
• CHANGES in Chr-13q in GERM-CELL Mutations
• Occur at SEVERAL Locations in Retina or BILATERALLY

Question 4

What are the SYMPTOMS of RETINOBLASTOMA?

Answer 4

• Manifests BEFORE Age 3 y/o
• Parents OBSERVE LEUKOCORIA (White-Yellow Pupil) = 60%
• Parents OBSERVE STRABISMUS = 20% - MUST UNDERGO examination of FUNDUS with PUPIL DILATED to EXCLUDE the Retinoblastoma
• Parents OBSERVE REDDENED EYE= 10%

Question 5

What are the CLINCIAL FINDINGS of RETINOBLASTOMA?

Answer 5

• A GREY-WHITE Vascularised Retinal Tumour is OBSERVED upon OPHTHALMOSCOPY
• INFILTRATION of Vitreous Body / Anterior Chamber / Orbit
• CALCIFICATIONS occur = Detected via CT Imaging

Question 6

What is the DIFFERENTIAL DIAGNOSIS against RETINOBLASTOMA?

Answer 6

• Cataract
• Primary Strabismus
• Infection
• Retinal Detachment

Question 7

What is the TREATMENT for RETINOBLASTOMA?

Answer 7

IF Tumour is LESS than 4 Pupil Diameters = RADIATION THERAPY

a. using Radioactive Ruthenium
b. using Radioactive Iodine
c. Cryotherapy

IF Tumour is LARGE = ENUCLEATION of the eye