Retinoblastoma differential diagnosis: Difference between revisions
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*Presents at birth. | *Presents at birth. | ||
*Lens opacification rare in retinoblastoma | *Lens opacification rare in retinoblastoma | ||
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*Fundus examination reveals lens opacification | *Fundus examination reveals lens opacification | ||
*Ultrasound shows increased echogenicity of lens | *Ultrasound shows increased echogenicity of lens | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Coats disease (exudative retinitis or retinal telangiectasis) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Coats disease (exudative retinitis or retinal telangiectasis) | ||
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*Most cases are unilateral | *Most cases are unilateral | ||
*Mean age at presentation is 6 years | *Mean age at presentation is 6 years | ||
*More common in males | *More common in males | ||
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*Fundus examination: lesion appears more yellow-colored (versus chalky white-gray in retinoblastoma); telangiectatic and aneurysmal retinal vessels are characteristic of Coats disease but uncommon in retinoblastoma. | *Fundus examination: lesion appears more yellow-colored (versus chalky white-gray in retinoblastoma); telangiectatic and aneurysmal retinal vessels are characteristic of Coats disease but uncommon in retinoblastoma. | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) | ||
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*Associated with a micro-ophthalmic eye (a small, malformed eye) | *Associated with a micro-ophthalmic eye (a small, malformed eye) | ||
*Often associated with a cataract (rare in retinoblastoma) | *Often associated with a cataract (rare in retinoblastoma) | ||
*Congenital (retinoblastoma uncommonly presents at birth) | *Congenital (retinoblastoma uncommonly presents at birth) | ||
*Dragging of the ciliary processes on exam | *Dragging of the ciliary processes on exam | ||
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*Measurement of axial length using fundus examination and ultrasound shows short axial length in persistent fetal vasculature. | *Measurement of axial length using fundus examination and ultrasound shows short axial length in persistent fetal vasculature. | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Retinopathy of prematurity (ROP) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Retinopathy of prematurity (ROP) | ||
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*Generally occurs in premature children given high-dose oxygen | *Generally occurs in premature children given high-dose oxygen | ||
*Can result in total retinal detachment | *Can result in total retinal detachment | ||
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*Fundus examination: reveals gliotic-appearing retina, which is different from the retinal detachment associated with retinoblastoma. | *Fundus examination: reveals gliotic-appearing retina, which is different from the retinal detachment associated with retinoblastoma. | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Ocular toxocariasis | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Ocular toxocariasis | ||
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*Generally causes vitreoretinal traction and ocular inflammation not seen in retinoblastoma | *Generally causes vitreoretinal traction and ocular inflammation not seen in retinoblastoma | ||
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*Fundus examination reveals the characteristic signs | *Fundus examination reveals the characteristic signs | ||
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==References== | ==References== |
Revision as of 19:04, 16 October 2015
Retinoblastoma Microchapters |
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Case Studies |
Retinoblastoma differential diagnosis On the Web |
American Roentgen Ray Society Images of Retinoblastoma differential diagnosis |
Risk calculators and risk factors for Retinoblastoma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Retinoblastoma must be differentiated from other diseases that cause leukocoria, such as congenital cataract, persistent fetal vasculature, Coats disease, cloboma of choroid or optic disc, toxocariasis, astrocytic hamartoma, retinopathy of prematurity, vitreous hemorrhage, uveitis, retinal dysplasia, and medulloepithelioma.[1]
Differential diagnosis
Retinoblastoma must be differentiated from other diseases that cause leukocoria. The common causes of leukocoria in children include:[1]
- Congenital cataract
- Persistent fetal vasculature
- Coats disease
Less common causes of leukocoria include:
- Coloboma of choroid or optic disc
- Toxocariasis
- Astrocytic hamartoma
- Retinopathy of prematurity (stage 4, 5)
- Vitreous hemorrhage
- Uveitis
Differentiating features of some common and less common differential diagnosis are:
Disease/Condition | Differentiating Signs/Symptoms | Differentiating Tests |
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Congenital Cataract |
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Coats disease (exudative retinitis or retinal telangiectasis) |
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Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) |
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Retinopathy of prematurity (ROP) |
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Ocular toxocariasis |
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References
- ↑ 1.0 1.1 Retinoblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Retinoblastoma#cite_note-30 Accessed on October 2 2015