Retinoblastoma differential diagnosis: Difference between revisions

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{{CMG}},{{AE}}{{Simrat}}
{{CMG}},{{AE}}{{Simrat}}
==Overview==
==Overview==
Retinoblastoma must be differentiated from other diseases that cause [[leukocoria]], such as [[congenital]] [[cataract]], persistent fetal vasculature, [[Coats disease]], cloboma of [[choroid]] or [[optic disc]], [[toxocariasis]], [[astrocytic]] [[hamartoma]], [[retinopathy of prematurity]], [[vitreous hemorrhage]], [[uveitis]], [[retinal dysplasia]], and [[medulloepithelioma]].<ref name="wiki">  Retinoblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Retinoblastoma#cite_note-30 Accessed on October 2 2015</ref>
Retinoblastoma must be differentiated from other diseases that cause [[leukocoria]], such as [[congenital]] [[cataract]], persistent fetal vasculature, [[Coats disease]], [[coloboma]] of [[choroid]] or [[optic disc]], [[toxocariasis]], [[astrocytic]] [[hamartoma]], [[retinopathy of prematurity]], [[vitreous hemorrhage]], [[uveitis]], [[retinal dysplasia]], and [[medulloepithelioma]].<ref name="wiki">  Retinoblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Retinoblastoma#cite_note-30 Accessed on October 2 2015</ref>
==Differential diagnosis==
==Differential diagnosis==
Retinoblastoma must be differentiated from other diseases that cause [[leukocoria]]. The common causes of leukocoria in children include:<ref name="wiki">  Retinoblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Retinoblastoma#cite_note-30 Accessed on October 2 2015</ref>
Retinoblastoma must be differentiated from other diseases that cause [[leukocoria]]. The common causes of leukocoria in children include:<ref name="wiki">  Retinoblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Retinoblastoma#cite_note-30 Accessed on October 2 2015</ref>
Line 10: Line 10:
*[[Coats disease]]
*[[Coats disease]]
Less common causes of leukocoria include:
Less common causes of leukocoria include:
*Coloboma of [[choroid]] or [[optic disc]]
*[[Coloboma]] of [[choroid]] or [[optic disc]]
*[[Toxocariasis]]
*[[Toxocariasis]]
*[[Astrocytic ]][[hamartoma]]
*[[Astrocytic ]][[hamartoma]]

Revision as of 19:05, 16 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Retinoblastoma must be differentiated from other diseases that cause leukocoria, such as congenital cataract, persistent fetal vasculature, Coats disease, coloboma of choroid or optic disc, toxocariasis, astrocytic hamartoma, retinopathy of prematurity, vitreous hemorrhage, uveitis, retinal dysplasia, and medulloepithelioma.[1]

Differential diagnosis

Retinoblastoma must be differentiated from other diseases that cause leukocoria. The common causes of leukocoria in children include:[1]

Less common causes of leukocoria include:

Differentiating features of some common and less common differential diagnosis are:

Disease/Condition Differentiating Signs/Symptoms Differentiating Tests
Congenital Cataract
  • Presents at birth.
  • Lens opacification rare in retinoblastoma
  • Fundus examination reveals lens opacification
  • Ultrasound shows increased echogenicity of lens
Coats disease (exudative retinitis or retinal telangiectasis)
  • Most cases are unilateral
  • Mean age at presentation is 6 years
  • More common in males
  • Fundus examination: lesion appears more yellow-colored (versus chalky white-gray in retinoblastoma); telangiectatic and aneurysmal retinal vessels are characteristic of Coats disease but uncommon in retinoblastoma.
  • Spectral domain optical coherence tomography may be helpful in distinguishing Coats disease from retinoblastoma.
  • Ophthalmic ultrasound: can be misleading because calcification can also be seen in Coats disease.
Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous)
  • Associated with a micro-ophthalmic eye (a small, malformed eye)
  • Often associated with a cataract (rare in retinoblastoma)
  • Congenital (retinoblastoma uncommonly presents at birth)
  • Dragging of the ciliary processes on exam
  • Measurement of axial length using fundus examination and ultrasound shows short axial length in persistent fetal vasculature.
Retinopathy of prematurity (ROP)
  • Generally occurs in premature children given high-dose oxygen
  • Can result in total retinal detachment
  • Fundus examination: reveals gliotic-appearing retina, which is different from the retinal detachment associated with retinoblastoma.
Ocular toxocariasis
  • Generally causes vitreoretinal traction and ocular inflammation not seen in retinoblastoma
  • Fundus examination reveals the characteristic signs

References

  1. 1.0 1.1 Retinoblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Retinoblastoma#cite_note-30 Accessed on October 2 2015

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