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Posters

Intraocular infection masquerading as retinoblastoma clinically and in magnetic resonance imaging - diagnostic challenge

Poster Details

First Author: S.Ganesan INDIA

Co Author(s):    V. khetan   T. Sharma               0   0 0   0 0   0 0   0 0

Abstract Details



Purpose:

To report two cases of intraocular infection presenting with clinical, sonographical and MRI features of advanced Retinoblastoma

Setting:

Tertiary hospital

Methods:

Retrospective analysis of case records and review of the histopathology of two patients of intraocular infection presenting as retinoblastoma

Results:

Case 1 A 4½-year-old boy presented with leucocoria. Examination revealed circumciliary congestion, corneal odema, neovascularisation of iris, ectropion uveae and retrolental yellowish white reflex with intraocular pressure of 52 mm Hg . Sonography revealed moderate reflective ill defined mass lesion with specks of high reflective clump echoes with total retinal detachment . MRI showed T2 hypointense intraocular mass along detached retinal leaflets. After enucleation, histologic examination revealed caseating granulomatous inflammation . PCR for MTb on paraffin section was positive. Antituberculous treatment was started Case 2 A 4 -year-old boy presented with leucocoria . Examination revealed fibrin, pigments on lens capsule and retolental white reflex with IOP of 40mmhg. Sonography revealed total retinal detachment with thickened leaflets with plenty of subretinal echoes. MRI showed irregular T2 hypointense intraocular lesion displaying intermediate signal in T1W1 with restricted diffusion measuring 13.3mm X 9.6mm. Histologic examination after enucleation was suggestive of severe intraocular inflammation. Systemic evaluation was normal

Conclusions:

Diagnostic differentiation of advanced stages of Retinoblastoma from other masquerader’s is a never ending challenge for ophthalmologists and radiologists. Intraocular infection can present like advanced retinoblastoma. Retinoblastoma being an invasive disease and a privileged tumor one has to resort to end stage procedures like enucleation and histopathology to clinch the diagnosis. Need for diagnostic differentiation to permit maximum ocular salvage and to minimize mortality is crucial.

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