Head and Eye Trauma Before Retinoblastoma Diagnosis

PURPOSE: To improve public and medical awareness of the possibility of retinoblastoma (RB) in children who experienced inadvertent trauma with or without trauma-related symptoms and signs. PATIENTS AND METHODS: Retrospective study of the clinical characteristics of children with a trauma history preceding a diagnosis of RB at the Zhongshan Ophthalmic Center, Sun Yat-sen University, between January 2013 and August 2018, and the number of children hospitalized with eye trauma during the same period. RESULTS: Among 793 consecutive patients with RB, 10 (1.3%) had a history of trauma. Two of these 10 patients (20%, accounting for nearly 0.2% of the 1103 eye trauma patients who were treated at our center) had undergone vitrectomy in an eye with unsuspected tumors. Of the 10 cases (12 eyes), only 5 (7 eyes) were initially diagnosed with RB or an intraocular space-occupying mass before referral to the oncology clinic, and 8 patients (80%) with 8 eyes that were ultimately staged as cT2b or higher underwent enucleation on referral to the oncology clinic. Although additional treatment was performed, two of these patients experienced intracranial metastasis and death during a mean follow-up time of 25.9 months from treatment. CONCLUSION: More attention should be paid to the possibility of underlying RB in children of preschool age who have experienced trauma with or without eye signs.