Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Eye Center, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China.
Department of Ophthalmology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
BMC Ophthalmol. 2023 Feb 28;23(1):81. doi: 10.1186/s12886-023-02819-2.
To report a case series of patients who were diagnosed with retinoblastoma (RB), which was preceded by trauma, in a large multicenter cohort and to investigate the incidence, clinical characteristics, and causes of RB misdiagnosis.
The medical records of consecutive patients with RB between 2006 and 2015 were retrospectively reviewed. Characteristics of trauma patients, including their age at initial trauma, site of trauma, sex, and RB laterality, were analyzed.
Among 3780 patients, 30 (0.8%) experienced systemic or ocular trauma prior to the detection of RB. The median age was 20.7 months, and the median follow-up time was 6 years. There were 2 eyes in stage A, 2 in stage B, 3 in stage C, 12 in stage D, and 15 in stage E. The remaining 2 eyes had extraocular RB. A total of 20 patients experienced ocular trauma, 9 patients experienced head trauma, and 1 patient experienced trauma in other body parts. RB was suspected or detected in 22 patients (73.3%) at the time of primary trauma occurrence, and 8 patients (26.7%) were misdiagnosed with RB during their first visit. Among them, all experienced blunt ocular trauma, and enucleation was performed in 7 patients in which 1 patient died.
Less than 1% of the patients experienced systemic or ocular trauma before RB was detected. The majority were unilateral and in advanced stages. Differential diagnoses that are not trauma-related must always be considered, and comprehensive examinations must be conducted before diagnostic and therapeutic intraocular procedures are initiated.
报告一个大型多中心队列中，由创伤引起的视网膜母细胞瘤（RB）病例系列，并探讨 RB 误诊的发生率、临床特征和原因。
回顾性分析 2006 年至 2015 年间连续就诊的 RB 患者的病历。分析创伤患者的特征，包括初次创伤时的年龄、创伤部位、性别和 RB 的侧别。
在 3780 例患者中，有 30 例（0.8%）在发现 RB 之前经历过全身或眼部创伤。中位年龄为 20.7 个月，中位随访时间为 6 年。有 2 只眼处于 A 期，2 只眼处于 B 期，3 只眼处于 C 期，12 只眼处于 D 期，15 只眼处于 E 期。其余 2 只眼有眼外 RB。共有 20 只眼发生眼部创伤，9 只眼发生头部创伤，1 只眼发生其他身体部位创伤。22 例（73.3%）患者在初次创伤时怀疑或发现 RB，8 例（26.7%）患者在首次就诊时被误诊为 RB。其中，所有患者均经历过钝器眼部创伤，7 例患者接受了眼球摘除术，其中 1 例患者死亡。
不到 1%的患者在发现 RB 之前经历过全身或眼部创伤。大多数为单侧且处于晚期。必须始终考虑与创伤无关的鉴别诊断，并在进行诊断和治疗性眼内手术之前进行全面检查。
