ABSTRACT
@#Diminished vision due to choroidal metastasis as the first manifestation of lung carcinoma is rare. Here, we report a case of a 22-year-old non-smoker man, with no known medical illness presented with painless loss of vision in the right eye for one month, which became painful after two weeks. The anterior segment examination of the right eye revealed an anteriorly subluxated crystalline lens with angle-closure glaucoma secondary to a retrolental choroidal mass. Prompt assessment and investigation revealed right eye choroidal metastasis secondary to small cell carcinoma. The right eye responded well to chemotherapy evidenced by a reduction of intraocular pressure and size of the choroidal mass. It is crucial to have a high index of suspicion to exclude non-ocular primary tumours as probable causes in any choroidal masses.
ABSTRACT
@#Retinoblastoma very rarely presents as vitreous haemorrhage. We are presenting a case of atypical presentation of retinoblastoma in a 3-year-old girl. She initially came with right eye vitreous haemorrhage of unknown cause. B-mode ultrasound showed dense vitreous opacity without evidence of mass. Initial MRI Brain/Orbit was inconclusive. Diagnostic vitrectomy was performed and noted thickened abnormal retina which was suspicious for retinoblastoma. The parents refused for enucleation for diagnostic histopathological examination and opted for conservative management. Repeated MRI Brain/Orbit done six months later showed disease progression through optic nerve involvement and suggestive of retinoblastoma. The parents were re-counselled for enucleation however refused and defaulted. 2 months later, the child was brought back with proptosed and disorganized eye. This time, they agreed for intervention. The patient underwent three cycles of chemoreduction therapy before enucleation. After enucleation, she received six cycles of adjuvant chemotherapy. She was well with no disease recurrence at two-year post treatment.