Echography in retinoblastoma

Echography of retinoblastoma: histopathologic correlation and serial evaluation after globe-conserving radiotherapy or chemotherapy

PURPOSE

To assess the sensitivity of echography in detecting retinoblastoma, compare tumor features observed by echography with histopathology data, and assess the usefulness of echography in serially following retinoblastoma tumors after globe-conserving treatments.

METHODS

The medical and echography records of all patients treated for retinoblastoma at the Bascom Palmer Eye Institute between 1991 and 1997 were reviewed. All eyes underwent pretreatment echographic evaluation, and eyes treated with external beam radiotherapy, brachytherapy, or chemotherapy underwent serial follow-up echography.

RESULTS

Sixty-nine eyes of 48 patients were identified. Echography demonstrated evidence of retinoblastoma in 69 of 69 (100%) eyes and calcification in 63 (91.3%) eyes. Histopathology was superior to echography in detecting optic nerve invasion, extraocular extension, and presence of calcification.

CONCLUSION

Echography is a useful adjunct to indirect ophthalmoscopy in establishing the diagnosis of retinoblastoma. While not as specific as histopathology, echographic evaluation before and after treatment of retinoblastoma permits monitoring of treatment response and may aid in detecting recurrent tumor growth or failure to respond to treatment.

Ultrasound in the Evaluation of Leukocoria

Infantile leukocoria, a white pupillary reflex, is the result of various neoplastic, inflammatory, hemorrhagic, or congenital ocular conditions. Combined B and A scan ultrasonography is a safe, easily performed, highly informative diagnostic technique which aids in the identification of ocular pathology (even when ophthalmoscopic examination is precluded). This report summarizes the clinical course, pathologic findings, and acoustic characteristics of retinoblastoma, persistent hyperplastic primary vitreous, Coats' disease, retrolental fibroplasia, vitreous hemorrhage, congenital cataract, and ocular toxocariasis.