Glaucoma in Retinoblastoma

Leon, John Mark de; Walton, David S.; Latina, Mark A.; Mercado, Gary

doi:10.1080/08820530500353831

Cited by 18 publications

(6 citation statements)

References 27 publications

(47 reference statements)

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“…Up to 17%-22.8% of patients with retinoblastoma have increased intraocular pressures typically due to iris neovascularization. 6,7 However, with diffuse infiltrating retinoblastoma subtypes, glaucoma can result from neoplastic seeding of the trabecular meshwork in the anterior chamber, causing outflow obstruction of the aqueous humor. 6 Retinoblastoma has 4 different growth patterns: endophytic growth toward the vitreous, exophytic growth toward the choroid, mixed exophytic and endophytic growth (most common), and diffuse infiltrating growth.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 However, with diffuse infiltrating retinoblastoma subtypes, glaucoma can result from neoplastic seeding of the trabecular meshwork in the anterior chamber, causing outflow obstruction of the aqueous humor. 6 Retinoblastoma has 4 different growth patterns: endophytic growth toward the vitreous, exophytic growth toward the choroid, mixed exophytic and endophytic growth (most common), and diffuse infiltrating growth. Diffuse infiltrating retinoblastoma is rare, accounting for only 1%-2% of all cases, 1,8 and is characterized by plaquelike thickening of the ret- ina without a discrete mass lesion.…”

Section: Discussionmentioning

confidence: 99%

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Anterior-Segment Retinoblastoma Mimicking Pseudoinflammatory Angle-Closure Glaucoma: Review of the Literature and the Important Role of Imaging

Saket

Mafee²

2009

AJNR Am J Neuroradiol

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SUMMARY:A 7-year-old boy presented with angle-closure glaucoma, initially presumed to be idiopathic. A ciliary body mass was later detected on MR imaging, suggestive of medulloepithelioma but pathologically proved to be diffuse infiltrating retinoblastoma. We discuss the patient management and review the literature, with emphasis on the role of CT and MR imaging in evaluating pediatric angle-closure glaucoma and in influencing the management of patients with retinoblastoma and medulloepithelioma. Retinoblastoma is the most common intraocular tumor in children. Ninety-five percent of cases occur in patients younger than 5 years with a mean age of 18 months.1 Medulloepithelioma occurs in older children, with mean age of 4 years.2,3 As opposed to retinoblastoma, which typically arises in the sensory retina, medulloepithelioma almost always occurs in the ciliary body and is the primary consideration for an anterior segment mass in pediatric patients. 1-3The most frequent alternative diagnosis for a pediatric anterior segment mass is diffuse infiltrating retinoblastoma. Compared with conventional retinoblastomas, this variant typically occurs in older pediatric patients, overlapping the age group of medulloepithelioma. 2,4,5 Given that both can elevate intraocular pressures, imaging plays an important role in identifying neoplastic etiologies in children with angle-closure glaucoma. Furthermore, MR imaging defines the local extent of such lesions, profoundly impacting management. Case ReportA 7-year-old boy presented with left orbital pain, decreased vision, and findings of cataracts and angle-closure glaucoma with unrevealing funduscopic examination and orbital sonography. Six months after undergoing an Ahmed anterior chamber shunt surgery procedure for presumed idiopathic angle-closure glaucoma, he developed a white anterior chamber mass, initially believed to be a hypopyon from presumed granulomatous uveitis. He then underwent a nonconjunctival-disrupting procedure with fine-needle aspiration. Cytologic analysis revealed small malignant cells with scant cytoplasm, positive for synaptophysin and chromogranin immunostains, yielding a preliminary diagnosis of retinoblastoma.CT and MR imaging of the orbits demonstrated a noncalcified diffuse infiltrating mass involving a detached retina and anterior segment in the left globe (Fig 1), suggesting either advanced medulloepithelioma or diffuse infiltrating retinoblastoma. The patient subsequently underwent enucleation, providing a final pathologic diagnosis of retinoblastoma (Fig 2). DiscussionGlaucoma in the first decade of life should be thoroughly evaluated for an ocular neoplasm. Up to 17%-22.8% of patients with retinoblastoma have increased intraocular pressures typically due to iris neovascularization.6,7 However, with diffuse infiltrating retinoblastoma subtypes, glaucoma can result from neoplastic seeding of the trabecular meshwork in the anterior chamber, causing outflow obstruction of the aqueous humor. 6Retinoblastoma has 4 different growth patterns: endophytic...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anterior-Segment Retinoblastoma Mimicking Pseudoinflammatory Angle-Closure Glaucoma: Review of the Literature and the Important Role of Imaging

Saket

Mafee²

2009

AJNR Am J Neuroradiol

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Section: Tumor-related Glaucomamentioning

confidence: 99%

“…Ciliary body melanomas are frequently involved, with an increase in pressure in 17 % of cases, whereas choroidal melanomas only have elevated intraocular pressure in about 2 % of cases [41]. Glaucoma in retinoblastoma has been described in 1-23 % of cases [42]. Several mechanisms may lead to an increase in pressure: direct infiltration of the chamber angle, tumor spread into the trabecular meshwork, obstruction of the trabecular meshwork by pigment, cells and debris from necrotizing tumors, neovascularization, and angle block due to advancement of the iris base or iris-lens diaphragm.…”

Section: Tumor-related Glaucomamentioning

confidence: 99%

Sekundärglaukome im Rahmen retinaler Erkrankungen

Greslechner

Helbig

2022

Klin Monbl Augenheilkd

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Zusammenfassung: Eine Vielzahl retinaler Erkrankungen kann zur Entwicklung eines Glaukoms führen. Die häufigste Form dieser Sekundärglaukome sind die Neovaskularisationsglaukome, die den Hauptteil dieser Übersicht bilden. Dabei handelt sich um ein schwerwiegendes Krankheitsbild, dass in mehreren Stadien verläuft, wobei die Prognose mit zunehmendem Stadium ungünstiger und die Therapie herausfordernder wird. Neben Pathogenese und Diagnostik wird daher ein Schwerpunkt wird auf die Früherkennung und eine an das jeweilige Krankheitsstadium angepasste Therapie gelegt. Auch seltenere Sekundärglaukome im Rahmen intraokularer Tumore sowie Glaukome assoziiert mit einer Netzhautablösung (Schwartz-Matsuo Syndrom) und Glaukome, die im Spätverlauf nach unkomplizierter Vitrektomie auftreten, werden in dieser Übersicht diskutiert. Abstract: A variety of retinal diseases can lead to the development of glaucoma. The most common type of these secondary glaucomas is neovascular glaucoma (NVG), which constitutes the main subject of this review. NVG is a severe condition with a poor prognosis. Treatment gets increasingly challenging as the disease progresses. Thus emphasis is put on early diagnosis and an stage adjusted therapy. Other less frequent secondary glaucomas, such as glaucomas due to intraocular tumors or associated with retinal detachment (Schwartz-Matsuo syndrome) and late onset open-angle glaucomas after uncomplicated vitrectomy are covered.

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“…13,14 An angle-closure glaucoma as a presenting feature of RB may signify neoplastic seeding of the anterior chamber and iris neovascularization. 15 Clinical presentations may differ depending on patterns of tumor growth. Endophytic tumors, which arise from internal retinal layers, grow anteriorly into the vitreous, with consequent tendency to vitreous seeding.…”

Section: Retinoblastoma Clinical Featuresmentioning

confidence: 99%

Retinoblastoma: Advanced Imaging, Clinical Approach

Feygin

Leahey

2016

J Pediatr Neuroradiol

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Retinoblastoma (RB) is a malignant tumor of the retina and the most common intraocular pediatric tumor. It typically affects children younger than 4 years of age. Loss or mutation of RB genes causes absence of RB control protein and subsequent uncontrolled cell division and tumor growth. In this review article, we describe how two forms of RB?germline (40%) and somatic sporadic (60%)?differ in their clinical presentation and prognosis. The accurate diagnosis, staging, and monitoring of the disease may be achieved with a combination of ophthalmologic examination, genetic analysis, and modern imaging. We refer to a spectrum of clinical and imaging modalities, which may be used in the diagnosis of RB. The advantages and shortcomings of ocular ultrasound, orbital computed tomography, and magnetic resonance imaging (MRI) are described. Modern imaging protocols allow for better assessment of disease extension and can help make treatment decisions for eye-sparing procedures in some cases to avoid enucleation. Essential components of optimal orbital MRI are emphasized. The roles of various MRI sequences are highlighted for demonstration of original tumor morphology and extension, and for the accurate assessment of disease progression and response of RB to treatment on follow-up examinations. Imaging features of aggressive or advanced disease and normal appearance of posttreatment eye and posttreatment complications are also illustrated.

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Glaucoma in Retinoblastoma

Cited by 18 publications

References 27 publications

Anterior-Segment Retinoblastoma Mimicking Pseudoinflammatory Angle-Closure Glaucoma: Review of the Literature and the Important Role of Imaging

Anterior-Segment Retinoblastoma Mimicking Pseudoinflammatory Angle-Closure Glaucoma: Review of the Literature and the Important Role of Imaging

Sekundärglaukome im Rahmen retinaler Erkrankungen

Retinoblastoma: Advanced Imaging, Clinical Approach

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