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Retrolental white mass
A Buyck1, I Casteels, L Dralands
1Department of Ophthalmology, U.Z. K.U.L., Leuven.
Insights
A retrolental white mass in children can indicate several conditions, including retinoblastoma and Coats
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Medical Imaging
Background:
- Retrolental white mass is a concerning sign in pediatric patients.
- Differential diagnosis is crucial for appropriate management.
Purpose of the Study:
- To analyze the causes of retrolental white mass in children.
- To identify age-related presentation patterns for different conditions.
Main Methods:
- Retrospective review of 23 pediatric cases presenting with retrolental white mass between 1985 and 1990.
- Clinical examination including funduscopy under general anesthesia.
- Diagnostic imaging (ultrasound) and cytological analysis were utilized.
Main Results:
- Retinoblastoma and Coats' disease presented in children over eight months.
- Persistent hyperplastic primary vitreous and retinopathy of prematurity presented before six months.
- Funduscopy focusing on vasculature, ultrasound, and subretinal fluid cytology aid diagnosis.
Conclusions:
- Age at presentation is a key differentiator for retrolental white mass causes.
- Careful funduscopy and ancillary tests are essential for distinguishing between retinoblastoma and Coats' disease.
Abstract:
From 1985 till 1990 twenty-three children aged seven weeks to six years presented with a retrolental white mass. Six children had retinoblastoma, six Coats' disease, five retinopathy of prematurity, four persistent hyperplastic primary vitreous, one cysticercosis and one retinal detachment. Retinoblastoma and Coats' disease was only seen in children over eight months, whereas persistent hyperplastic primary vitreous and retinopathy of prematurity all presented before the age of six months. Differentiation between Coats' disease and retinoblastoma is not always easy. Most helpful for the diagnosis is to perform funduscopy under general anaesthesia with special attention to the vasculature. Ultrasounds are helpful, but can give confusing results. Cytological analysis of subretinal fluid is useful in Coats' disease.