Retinoblastoma presenting as haemorrhagic choroidal detachment in a 10-year-old girl

Abstract

To report a case of retinoblastoma presenting as haemorrhagic choroidal detachment in a 10-year-old girl. The patient, apparently well, presented with sudden blurring of vision in the setting of blunt trauma. On examination and ocular ultrasound, haemorrhagic choroidal detachment was suspected. She underwent external drainage via sclerostomies. The haemorrhage resolved ultrasonographically, but the vision did not improve. Five months postoperatively, she presented with sudden eye pain, lid swelling and proptosis. The ancillary workups were consistent with panophthalmitis and was treated as such. Six months postoperatively, the pain and lid swelling persisted; hence, the painful near absolute eye was enucleated. The histopathology revealed small round blue cells with necrosis consistent with retinoblastoma. Immunohistochemistry was positive for synaptophysin and negative for S100 confirming retinoblastoma. Retinoblastoma is the most common intraocular malignancy in children. The importance of increased awareness of its various presentations is of utmost importance to prevent life-threatening and vision-impairing complications.

Classification of Childhood Glaucoma in Patients of a Government Tertiary Hospital in Manila, Philippines using the Childhood Glaucoma Research Network System

“…Notably, there were three cases of acquired glaucoma secondary to malignancies: retinoblastoma, intraocular bleed from ALL, and 1 intracranial tumor. 19 Secondary glaucoma from non-acquired, systemic conditions was only recorded in one case of Sturge-Weber syndrome (1.3%). Other studies in Dallas, Minnesota, Florida, and Toronto, had a higher prevalence of glaucoma associated with systemic conditions, ranging from 6.8-13.3% prevalence.…”

“…Persistent eye pain and poor vision led to enucleation and histopathologic analysis of the eye showed necrosis and round blue cells with synaptophysin on immunohistochemistry, consistent with retinoblastoma. 19 Glaucoma is associated with non-acquired systemic conditions…”

“…Anterior chamber washout was done in one hyphema patient and in a patient with anterior chamber bleed with post-enucleation findings of retinoblastoma. 19 Silicone oil removal was done in a postretina surgery patient. Eight out of the 9 (88.9%) eyes that underwent surgical interventions had an IOP of below 21 mmHg on the final follow-up.…”