WELCOME TO MY PRESENTATION

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Gh.Naderian M.D Isfahan University of Medical
Scinces Department of Opthalmology
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leukocoria
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Leukocoria

• Definition
• A white pupillary reflex

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

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

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

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

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

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

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

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

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

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• Causes of Retinal Detachment in Children
• Retinopathy of prematurity
• Systemic diseases
• Incontinentia pigmenti
• Familial exudative vitreoretinopathy
• Trauma
• Toxocara
• Coats disease

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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

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NOTE

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

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THANKS FOR ATTENTION