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Retinoblastoma in older children
C L Shields1, J A Shields, P Shah
1Ocular Oncology Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.
Ophthalmology
|March 1, 1991
Summary
Retinoblastoma, a childhood eye cancer, can occur after age 5. Delayed diagnosis is common in older children, often due to misdiagnosis of symptoms like vitreous hemorrhage.
Area of Science:
- Ophthalmology
- Pediatric Oncology
Background:
- Retinoblastoma is typically diagnosed in children under 5.
- Late-presenting retinoblastoma in older children is less common but can occur.
Purpose of the Study:
- To investigate the characteristics and diagnostic challenges of retinoblastoma in patients over 5 years old.
Main Methods:
- Retrospective review of 400 consecutive retinoblastoma patients.
- Analysis of clinical data for 34 patients diagnosed after age 5.
Main Results:
- 8.5% of patients were diagnosed after age 5, with active tumors in 76% of these cases.
- Common presenting symptoms included leukocoria and decreased vision.
- Misdiagnosis was frequent, with cases treated for vitreous hemorrhage or Coats disease.
Conclusions:
- Retinoblastoma should be considered in older children with unexplained ocular symptoms, particularly vitreous hemorrhage or endophthalmitis.
- Increased clinical suspicion is crucial for timely diagnosis in this age group.