In children, the common causes include retinoblastoma, persistent hyperplastic primary vitreous (PHPV), retinopathy of prematurity, Coats disease, congenital cataract, and larval granulomatosis. Diagnosis of most of these conditions is based on the clinical history, fundoscopic examination, and ocular US performed by the ophthalmologist and may not require additional imaging. Orbital Imaging and Vision Loss-Child CT Head and Orbits CT head and orbits with IV contrast may be helpful in differentiating various causes of leukocoria and also for the evaluation of the extension of retinoblastoma along optic nerves and intracranially. CT Head CT head with IV contrast may be helpful as an adjunct to the orbital imaging for the evaluation of intracranial spread of retinoblastoma. CT Orbits CT of the orbits with IV contrast may be helpful in differentiating various causes of leukocoria and also for the evaluation of the extension of the retinoblastoma along optic nerves. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children with leukocoria or suspected intraocular or orbital mass. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children with leukocoria or suspected intraocular or orbital mass. Retinopathy of prematurity and PHPV are associated with microphthalmia compared to normal sized globe in Coats disease or retinoblastoma. Absence of calcification on CT scan is important to differentiate PHPV and Coats disease from retinoblastoma. Postcontrast enhancement of the intraocular mass on MRI also helps to differentiate retinoblastoma from Coats disease, PHPV, or retinopathy of prematurity [2]. MRI Head MRI head with and without IV contrast may be useful as an adjunct to the orbital imaging for the evaluation of the intracranial extension of retinoblastoma.
Orbital Imaging and Vision Loss Child. In children, the common causes include retinoblastoma, persistent hyperplastic primary vitreous (PHPV), retinopathy of prematurity, Coats disease, congenital cataract, and larval granulomatosis. Diagnosis of most of these conditions is based on the clinical history, fundoscopic examination, and ocular US performed by the ophthalmologist and may not require additional imaging. Orbital Imaging and Vision Loss-Child CT Head and Orbits CT head and orbits with IV contrast may be helpful in differentiating various causes of leukocoria and also for the evaluation of the extension of retinoblastoma along optic nerves and intracranially. CT Head CT head with IV contrast may be helpful as an adjunct to the orbital imaging for the evaluation of intracranial spread of retinoblastoma. CT Orbits CT of the orbits with IV contrast may be helpful in differentiating various causes of leukocoria and also for the evaluation of the extension of the retinoblastoma along optic nerves. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children with leukocoria or suspected intraocular or orbital mass. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children with leukocoria or suspected intraocular or orbital mass. Retinopathy of prematurity and PHPV are associated with microphthalmia compared to normal sized globe in Coats disease or retinoblastoma. Absence of calcification on CT scan is important to differentiate PHPV and Coats disease from retinoblastoma. Postcontrast enhancement of the intraocular mass on MRI also helps to differentiate retinoblastoma from Coats disease, PHPV, or retinopathy of prematurity [2]. MRI Head MRI head with and without IV contrast may be useful as an adjunct to the orbital imaging for the evaluation of the intracranial extension of retinoblastoma.