Computed Tomography in the Evaluation of Childs with White Pupil

ABSTRACT

White pupil is one of the most disturbing problems in the pediatric age group and many conditions can cause white pupil, but the differential diagnosis between the retinoblastoma and other conditions simulating it, is the prime importance in the evaluation of the white pupil. The ophthalmoscopy is the most accurate diagnostic method for evaluating intraocular diseases because it is able to see directly. However, its usefulness seems to be limited in the case of extreme lens opacity or vitreous opacity and in the evaluation of orbital diseases extending outside of the globe. Recent advances of high resolution computed tomography(CT), the axial tomographic images of the orbit were markedly improved and represented good anatomic details of the orbit and the topographic relationship with surrounding structures. We reviewed CT findings of 15 children who presented white pupil and had results demonstrating specific findings in the cases of retinoblastoma, persistent hyperplastic primary vitreous and vitreous opacity due to retinal detachment and retrolental fibroplasia. The CT findings of each disease are discussed with detail.