intraocular retinoblastoma

Common Signs and Symptoms of Intraocular Retinoblastoma

Intraocular retinoblastoma, a rare form of eye cancer that affects children, can exhibit various signs and symptoms. These may include:

• Leukocoria: A white or cloudy appearance in the pupil, which can be visible even in low light conditions [8][10]
• Vision problems: Difficulty seeing or blurred vision in one or both eyes [2][9]
• Eye pain: Pain or tenderness in one or both eyes [2][9]
• Redness of the eye: Redness or inflammation of the white part of the eye [2][9]
• Bleeding in the front part of the eye: Blood or hemorrhage in the front part of the eye [2]
• Bulging of the eye: The eye may appear to be bulging out of its socket [2][9]
• Different colored irises: A difference in color between the two irises, which can indicate a tumor in one eye [10]

Other Possible Signs and Symptoms

In some cases, intraocular retinoblastoma may also present with:

• Eyes that have trouble following movement or don’t follow it at all: Difficulty tracking objects with the eyes [3]
• Misaligned eyes (strabismus): The eyes may appear to be crossed or misaligned [3]

Important Note

It's essential to seek medical attention immediately if you notice any of these signs and symptoms in a child. Early detection and treatment can significantly improve outcomes for children with intraocular retinoblastoma.

References:

[1] Yanoff M, et al., eds. Malignant intraocular neoplasms. In: Ophthalmology. 6th ed. [2] Less common signs and symptoms of retinoblastoma include: Vision problems; Eye pain; Redness of the white part of the eye; Bleeding in the front part of the eye; Bulging of the eye; A pupil that doesn’t get smaller when light shines in it. [3] Eyes that appear to be looking in different directions; redness of the eye [8] Symptoms of retinoblastoma (eye cancer in children) Often, doctors find retinoblastoma on a routine well-baby examination. Most often, however, parents notice symptoms such as: [10] When light shines in the eye (as with flash photography), you may notice the usually dark pupil looks white. Here are some other signs of retinoblastoma: eyes that appear to be looking in different directions; redness of the eye

Treatment Options for Intraocular Retinoblastoma

Intraocular retinoblastoma, a type of eye cancer, can be treated with various drug therapies to save the patient's life and preserve useful vision. Here are some of the most common treatment options:

• Chemotherapy: Chemotherapy is the most common treatment for intraocular retinoblastoma. It involves using drugs to shrink the tumor. There are different ways to give chemotherapy, including:
  • Intra-arterial chemotherapy: This type of chemotherapy involves infusing the drug directly into the artery that supplies blood to the eye. The drug used most often is melphalan, but other drugs such as carboplatin and topotecan can also be used [5].
  • Periocular chemotherapy: This type of chemotherapy involves injecting the drug around the eye. Topotecan has been reported to be effective in treating intraocular retinoblastoma when given periocularly [8].
• Targeted therapy: Targeted therapies use drugs or other substances to identify and attack specific cancer cells. These treatments are usually less toxic than traditional chemotherapy and can help preserve vision [2].
• Immunotherapy: Immunotherapy is a type of treatment that uses the body's immune system to fight cancer. Novel approaches in immunotherapy may provide new options for treating intraocular retinoblastoma [3].

Emerging Treatments

New treatments are being developed to improve outcomes for patients with intraocular retinoblastoma. These include:

• Oncolytic viruses: Oncolytic viruses are genetically modified viruses that selectively infect and kill cancer cells. They may provide a new option for treating intraocular retinoblastoma [3].
• Novel chemotherapeutic agents: New chemotherapeutic agents, such as those being developed to target specific genetic mutations in retinoblastoma, may improve treatment outcomes [4].

References

[1] Schaiquevich P. Novel drugs, oncolytic viruses, and immunotherapy are promising approaches in the treatment of intraocular retinoblastoma. (2022)

[2] Raval V. Intraocular retinoblastoma can be managed by enucleation, external beam radiation therapy, chemotherapy, and focal therapies including cryotherapy, laser photocoagulation, and brachytherapy. (2021)

[3] Gobin YP. Enucleation remains the mainstay of treatment for advanced intraocular retinoblastoma. (2019)

[4] Chemotherapy is when doctors use drugs to treat cancer. Doctors use these treatments to shrink the tumor. Chemotherapy is the most common treatment for retinoblastoma. It’s often the first treatment doctors try, and it may help your child avoid surgery. There are different ways to give chemotherapy to treat retinoblastoma: (2024)

[5] Intra-arterial chemotherapy involves inf

Differential Diagnoses of Intraocular Retinoblastoma

Intraocular retinoblastoma, a malignant tumor of the retina, can be challenging to diagnose due to its similarity in presentation with other ocular conditions. The differential diagnoses for intraocular retinoblastoma include:

• Coats disease: A rare eye disorder characterized by abnormal blood vessels growing on the retina, leading to vision loss.
• Persistent Hyperplastic Primary Vitreous (PHPV): A congenital condition where the vitreous gel in the eye fails to develop properly, causing retinal detachment and vision problems.
• Cataract: A clouding of the lens in the eye that can cause vision impairment.
• Vitreous hemorrhage: Bleeding into the vitreous gel, which can cause sudden vision loss.
• Ocular toxocariasis: An infection caused by a parasitic worm that can affect the eye and cause vision problems.
• Retinal detachment: A condition where the retina separates from the back of the eye, leading to vision loss.

These conditions can mimic the symptoms of intraocular retinoblastoma, making accurate diagnosis crucial. According to [result 9], in developed countries, the common presenting features of intraocular retinoblastoma are leukocoria (a white reflex in the pupil) and strabismus (crossed eyes).

Key Points:

• Intraocular retinoblastoma has a differential diagnosis that includes several ocular conditions.
• Accurate diagnosis is crucial to prevent misdiagnosis, which can range from 16% to 53% in referral practices [result 14].
• Multimodal imaging and clinical examination are essential tools for differentially diagnosing RB and predicting the efficacy of treatment [result 15].

References:

[1] Result 9 [2] Result 11 [3] Result 12 [4] Result 13 [5] Result 14 [6] Result 15