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بنام خداوند بخشنده مهربان

بنام خداوند بخشنده مهربان. G h.Naderian M.D Isfahan University of Medical Scinces Department of Opthalmology. leukocoria. Leukocoria. Definition : A white pupillary reflex. Leukocoria in a child requires urgent attention , primarily because in most patients with retinoblastoma it is the

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بنام خداوند بخشنده مهربان

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  1. بنام خداوند بخشنده مهربان Gh.Naderian M.DIsfahan University of Medical Scinces Department of Opthalmology

  2. leukocoria

  3. Leukocoria • Definition : A white pupillary reflex

  4. Leukocoria in a child requires urgent attention , primarily because in most patients with retinoblastoma it is the first sign noticed .

  5. Secondarily , a white pupil indicates a severely amblyopiogenic condition , which may be treatable .

  6. Anatomic location is important in the diffential diagnosis of Leukocoria .

  7. Normally , only the lens is found immediately behind the pupil , so an opacity here indicates a cataract .

  8. Advanced cases of persistent hyperplastic primary vitreous (PHPV)/persistent fetal vasculature (PFV) can also present with a posterior or total cataract.

  9. A cataract dose not exclude other causes of leukocoria . Therefore thoroughly examine the remainder of the eye.

  10. Cells or clumps in the vitreous indicate hemorrhage , infection , or tumor.

  11. Calcium in a retinal mass is highly typical for retinoblastoma, although not entirely pathognomic .

  12. Chorioretinal colobomas vary from very small to encompassing most of the fundus and optic nerve.

  13. Causes of Retinal Detachment in Children • ■ Retinopathy of prematurity • ■ Systemic diseases • Incontinentia pigmenti • Familial exudative vitreoretinopathy • ■ Trauma • ■ Toxocara • ■ Coat’s disease

  14. Work –up 1- History 2- Complete ocular examination 3- B Scan ultrasonoghraphy 4- Intravenous fluorescein angiogram (coats disease , ROP, retinoblastoma ) 5- CT or MRI 6- Serum ELISA 7- Anterior chamber paracentesis 8-EUA

  15. NOTE : • Anterior chamber paracentesis in a patients with a retinoblastoma can possibly led to tumor cell dissemination

  16. THANKS FOR ATTENTION

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