Journal of Pediatric Ophthalmology and Strabismus

Images in Pediatric Ophthalmology 

Vitreous Seeding in Retinocytoma: Importance of Optical Coherence Tomography

Aparna Ramasubramanian, MD; Amy Leverant, MD

Abstract

A 5-year-old boy with no family or personal history of retinoblastoma was incidentally noted to have a spot in the right eye. On examination, his visual acuity was 20/20 and there was a superior white intraretinal lesion (Figure 1A) with mild atrophy superiorly and no clinical vitreous seeding. Fluorescein angiography did not show any leakage and ultrasonography showed calcification suggestive of a retinocytoma. Optical coherence tomography (OCT) showed a clump of vitreous seeding (Figure 1B) branching off from the lesion. Retinocytoma is a rare benign variant of retinoblastoma, although malignant transformation has been reported.1 Vitreous seeding secondary to rupture of the internal limiting membrane has been reported with retinocytoma and OCT was used to demonstrate this when clinical seeding was not apparent.2,3 Based on this case, OCT imaging is recommended in all patients with retinocytoma to detect and monitor subtle vitreous seeding.…

A 5-year-old boy with no family or personal history of retinoblastoma was incidentally noted to have a spot in the right eye. On examination, his visual acuity was 20/20 and there was a superior white intraretinal lesion (Figure 1A) with mild atrophy superiorly and no clinical vitreous seeding. Fluorescein angiography did not show any leakage and ultrasonography showed calcification suggestive of a retinocytoma. Optical coherence tomography (OCT) showed a clump of vitreous seeding (Figure 1B) branching off from the lesion. Retinocytoma is a rare benign variant of retinoblastoma, although malignant transformation has been reported.1 Vitreous seeding secondary to rupture of the internal limiting membrane has been reported with retinocytoma and OCT was used to demonstrate this when clinical seeding was not apparent.2,3 Based on this case, OCT imaging is recommended in all patients with retinocytoma to detect and monitor subtle vitreous seeding.

References

  1. Uysal Y, Shields CL, Shields JA, Eagle RC Jr, . Malignant transformation of retinocytoma into retinoblastoma. Retin Cases Brief Rep. 2008;2(3):256–258. doi:10.1097/ICB.0b013e318154b70b [CrossRef]
  2. Abouzeid H, Balmer A, Moulin AP, Mataftsi A, Zografos L, Munier FL. Phenotypic variability of retinocytomas: preregression and postregression growth patterns. Br J Ophthalmol. 2012;96(6):884–889. doi:10.1136/bjophthalmol-2011-30089 [CrossRef]
  3. Garoon RB, Medina CA, Scelfo C, Harbour JW. Retinocytoma with vitreous seeding: new insights from enhanced depth imaging optical coherence tomography and high-resolution posterior segment ultrasonography. Preprint. Published online February 21, 2018. Retin Cases Brief Rep. doi:10.1097/ICB.0000000000000732 [CrossRef].
Authors

From Phoenix Children's Hospital, Phoenix, Arizona.

The authors have no financial or proprietary interest in the materials presented herein.

Correspondence: Aparna Ramasubramanian, MD, 1920 East Cambridge Avenue, Phoenix, AZ 85006-1464. Email: aramasubramanian@phoenix-childrens.com

10.3928/01913913-20200722-03

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