Coexistent Retinoblastoma and Retinopathy of Prematurity in a Preterm Infant

A preterm infant with gestational age of 29 weeks and birth weight of 1,300 grams was screened for retinopathy of prematurity (ROP) at 2 weeks of age in a tertiary care facility. Fundus examination revealed a demarcation line (stage 1 ROP) with group B retinoblastoma in both eyes along with peripheral avascular retina and shunt vessels during routine ROP screening. B-scan ultrasonography revealed intra-tumoral calcification, which was more evident in the left eye. Findings of magnetic resonance imaging of the brain and orbit corroborated with the diagnosis of bilateral retinoblastoma without any central nervous system involvement. Similar findings have been previously reported by Benz at al., where coexisting lesions were noted at postmenstrual age (PMA) of 36 weeks in a baby born at 24 weeks with a positive family history of retinoblastoma.¹ To the best of our knowledge, we report the earliest presentation, in terms of PMA, of simultaneous bilateral retinoblastoma and ROP.

Figure 1. (A) The wide field digital imaging (RetCam 3; Natus, Pleasanton, CA,) of right eye revealed a demarcation line (black arrow) with few ischemic areas along with a small tumor, approximately 1 disc diameter (white arrow) supero-temporal to fovea. (B) Widefield imaging of left eye showed early shunting of blood vessels, demarcation line and ischemic areas (black arrows) with a vascularized tumor at macula (white arrow) which is approximately 4 disc diameter in size.