Retinal tumor, retinal tumor / ocular fundus

Definition of retinoblastoma

Retinoblastoma is a tumor of the retina. This tumor is genetic, so hereditary. It usually occurs in childhood and is malignant.
Here you will find general information about tumor

How common is a retinoblastoma?

Retinoblastoma is a congenital tumor or it develops in early childhood. It is the most common ocular tumor in childhood. In about a third of cases, both eyes are affected. Also, more than one tumor can develop on one eye. Mostly the tumor develops before the third year of life. There are no preferences regarding gender or race distribution.

Recognition of a retinoblastoma

What are the symptoms of retinoblastoma?

The affected children are actually symptom free, ie they express no pain. It may occasionally happen that the children squint with a retinoblastoma. Therefore, in the case of cross-examined children, the ocular fundus is always examined during the initial examination (see ocular examination) in order to rule out such a tumor. Also, an inflammation of the eye, which persists for a long time can be an indication of a retinal tumor.

The typical distinguishing feature of retinoblastoma, however, is of a completely different nature: the parents come to the doctor with the child, because they have noticed a difference in the pupils in photos of the child. The children have a normal, red pupil and a different-looking, whitish pupil. The medical term for this is leucocoria (Greek leukos = white, kore = pupil).
At this stage, the retinoblastoma tumor has progressed so far that it already fills a large part of the vitreous space, which extends from the lens to the posterior pole of the eye. It is also called a cat's eye.

How is a retinoblastoma diagnosed?

The diagnosis of retinoblastoma is made by the ophthalmologist using the fundus mirror. This is done with a light source and a magnifying glass through the pupil and lens through looking into the back of the eye. Preferably vitreous space and retina are examined. The tumor can be recognized quite well and easily by its bulbous, whitish structure. If the tumor becomes too large, it breaks into the vitreous cavity. It can float parts of the tumor in the vitreous space.

Ultrasound, X-ray or a CT scan of the eye can also be performed. Here you can typically see calcification herds. However, these methods are more commonly used in dubious diagnoses and are not routine. Computed tomography also excludes scattering along the optic nerve.

Treating a Retinoblastoma

How is a retinoblastoma treated?

As already explained above, the tumor retinoblastoma is already well advanced at diagnosis and thus relatively large. In these cases, the eye must be removed. In this so-called enucleation, the largest possible distance (1 cm) of the optic nerve must be removed in order to avoid a possible spread of tumor cells.

For smaller tumors can also be treated with chemotherapy. In this case, the tumor usually shrinks slightly and the Aufnähung a radiation body, so with the procedures of radiation therapy is possible.
Tumors that are still small at diagnosis can be treated from the beginning with such a radiation body. If these retinoblastoma tumors are located on the outside of the retina, cryotherapy (cryotherapy) can be used.

Prevention of a retinoblastoma

How can a retinoblastoma be prevented?

Because retinoblastoma is hereditary, it can not be prevented. However, regular follow-up visits help to detect a possible recurrence of retinoblastoma early on. These follow-up checks must be carried out for 5 years. The second eye must also be thoroughly examined. To ensure this, the children should be placed in a short anesthetic. The pupils are dilated with eye drops.
In the first two years, the controls are every three months, then every six months or annually.

Course of a retinoblastoma

What is the prognosis of a retinoblastoma?

Thanks to state-of-the-art treatment options, the mortality rate for retinoblastoma, even if it occurs in both eyes, is only about 7%. However, if the optic nerve is affected, this number increases.

Even in cured patients tumors continue to occur in 20% of cases, be it on the other eye or even on bones. Therefore, these patients should be monitored to rule out future sequelae. In addition, the patients should be X-rayed as little as possible.

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