Secondary glaucoma in retinoblastoma
John Mark S. de Leon, MD1 Gary V. Mercado, MD2 David S. Walton, MD3
To investigate the causes of secondary glaucoma in retinoblastoma (RB) and underscore the significance of glaucoma as a presenting sign of RB.
A 7-month-old boy, initially diagnosed with congenital glaucoma in the left eye (OS), revealed an intraocular RB on further work-up. The eye was eventually enucleated and histopathology showed iris neovascularization (NVI) and a large solitary posterior-pole RB tumor with total retinal detachment. Using this as an illustrative case, a literature search on the relationship of glaucoma and RB was done to determine the incidence and the most common mechanisms of RB-induced glaucoma.
The most common mechanisms of secondary glaucoma in RB were: iris neovascularization (30–72%), pupillary block (27%), and tumor seeding of the anterior chamber (2%).
We presented a case of RB-induced glaucoma that mimicked congenital glaucoma. Awareness that RB may present initially as glaucoma is essential for appropriate evaluation and management.
Keywords: Retinoblastoma, Secondary glaucoma, Neovascularization, Pupillary block