1. بنام خداوند بخشنده مهربان
Gh.Naderian M.D Isfahan University of Medical Scinces Department of Opthalmology

2. leukocoria

3. Leukocoria
Definition :
A white pupillary reflex

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

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

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

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

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

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

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

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

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

14. Causes of Retinal Detachment in Children
■ Retinopathy of prematurity
■ Systemic diseases
Incontinentia pigmenti
Familial exudative vitreoretinopathy
■ Trauma
■ Toxocara
■ Coat’s disease

15. 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

16. NOTE :
Anterior chamber paracentesis in a patients with a retinoblastoma can possibly led to tumor cell dissemination

17. THANKS
FOR
ATTENTION