Eye diseases. Retinoblastoma and the reasons for its formation (the most important)

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Eye diseases. Retinoblastoma and the reasons for its formation (the most important)

Lecture notes, cheat sheets

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32. Retinoblastoma and its causes

Retinoblastoma (retinoblastoma) is a malignant neoplasm that develops in the retina of the eye. It refers to congenital tumors. It occurs in children as young as two to four years of age. Retinoblastoma can be either unilateral or bilateral. The disease is found more often in the first year of life.

The etiology has not been reliably established. A possible cause is considered to be a mutation of the chromosomes of germ cells due to internal and external factors. Retinoblastoma consists of neuroglia, that is, it is a glioma in its structure. Glia develops from the ectoderm and has great energy to reproduce and form new elements. Glial tissue permeates all layers of the retina and optic nerve.

There are differentiated and undifferentiated forms of the tumor. In undifferentiated forms, small cells with a large nucleus and a narrow rim of the cytoplasm are found.

There are five stages of tumor development:

1) latent;

2) primary;

3) developed;

4) far gone;

5) terminal.

The latent stage of retinoblastoma is characterized by such early indirect signs as unilateral dilation of the pupil, slowness or absence of its reaction to light. The initial stage is characterized by the fact that ophthalmoscopy reveals a yellowish-white lesion with unclear contours in the fundus, often covered with retinal vessels. Small satellite lesions are observed around the lesion. Tumor growth leads to amaurosis (blindness). The tumor can spread into the vitreous body in the form of grayish-white, sometimes yellowish or greenish masses with blurred boundaries, on the surface of which hemorrhages are visible. The process can spread across the retina (exophytic growth) and towards the vitreous body (endophytic growth). The advanced stage (glaucoma stage) is characterized by tumor growth and an increase in the volume of eye contents, which often leads to increased intraocular pressure. In this case, pain in the eye, stagnant injection, corneal edema, decreased depth and clouding of the anterior chamber fluid (pseudohypopyon) are possible.

Advanced stage (germination stage). This stage of retinoblastoma is characterized by tumor growth beyond the eyeball, more often through the sclera, along the vessels, through the sheaths of the optic nerve, etc. Posterior growth of the tumor is manifested by exophthalmos with limited eye mobility, the spread of the process into the cranial cavity causes an expansion of the optic nerve canal, which is detected on radiograph.

In the terminal stage (stage of metastases), enlarged cervical, submandibular lymph nodes are determined, further gross changes are observed from the side of the eye, up to the collapse of the membrane and the sharpest exophthalmos.

Author: Shilnikov L.V.

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