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Strabismus as a Presenting Sign in Retinoblastoma
Journal of Pediatric Ophthalmology and Strabismus
|September 30, 2021
Summary
Leukocoria and strabismus are common presenting signs of retinoblastoma (RB). Strabismus, particularly exotropia, is frequent and often indicates foveal involvement, impacting treatment decisions for this childhood eye cancer.
Area of Science:
- Ophthalmology
- Pediatric Oncology
Background:
- Retinoblastoma (RB) is the most common primary intraocular malignancy in children.
- Early detection of RB is crucial for successful treatment and vision preservation.
Purpose of the Study:
- To analyze the presenting signs of retinoblastoma (RB) in a large cohort undergoing orthoptic assessment.
- To investigate the association between presenting signs and foveal involvement in RB patients.
Main Methods:
- Retrospective chart review of 131 consecutive retinoblastoma patients over 6 years.
- Data collection focused on presenting signs, including leukocoria, strabismus, and inflammation.
- Orthoptic assessment was a key component of the initial evaluation.
Main Results:
- Leukocoria was the most frequent sign (56%), often combined with strabismus (18%).
- Strabismus was present in 31% of patients, with exotropia being the most common type (63%).
- Foveal involvement was observed in 75% of patients, significantly higher in those with strabismus (P = .001).
Conclusions:
- The combination of leukocoria and strabismus are key presenting features of retinoblastoma.
- Strabismus, especially exotropia, is common and linked to foveal involvement, influencing globe salvage decisions.
- Findings confirm exotropia as more prevalent than esotropia in retinoblastoma.
