Leukocoria Flashcards
Common causes of leukocoria
Toxocariasis
RB
Coats
ROP
Most common intraocular malignancy in children
Retinoblastoma
What types of RB are ALL inherited
ALL bilateral
Which type of RB is mostly not inherited
Unilateral
Some are inherited
Cause of RB
Mutations in the Rb tumor suppressor gene
What is ROP
Proliferative ret due to lack of development of peripheral BV=pre ret heme/vit heme + TRD=leukocoria
Who gets ROP
Premies (<32 weeks gestation), that were on O2 therapy
Temporal retinal vessels do not develop until 9th month of gestation
Treatment for ROP
PRP
Toxocariasis
Caused by nematode toxo canis
Unilateral, yellow, subretina granulomas=leukocoria
Young kids/adults
Eat dirt, infected veg/meat/water or contact with infected kitten/pup
Iritis, vitritis, subretinal granuloma, ON edema, TRD, scars
TX=steroids drop + systemic steroid + antiparasitic med
Coats disease
- idiopathic peripheral retinal vascular disease: unilateral, dilated, telangiectatic BV (light bulbs)=extensive hard exudates with steroids RD=leukocoria
- males (85%)<20 (66%) Dx prior to 10yo
- decreased VA, strabismus, leukocoria
- NVG
- later photocoagulation of telangiectatic vessels
Pica is assocaited with
Toxocariasis
Signs of RB
Solid, elevated, yellow-white intraocular tumor with overlying dilated vessels, leukocoria (50%), strabismus (18%), NVI (20%), decreased VA (5%)
95% of RB diagnosed by age
5
Heritable cases of RB
All bilateral cases and 10-20% of unilateral casee4s
- 85% of heritable cases are bilateral with multiple tumors
- only 6% have (+) famHx
- high rate of spontaneous mutation
- 50% risk of transmitting to offspring
Nonheritable RBs
60%
- 85% of unilateral cases
- 1 affected kid=6% risk of transmitting to next kid
- if 2+, 40% chance
