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First Author: L.Ortíz-León SPAIN
Co Author(s): E. Tomás-Verduras
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Leukocoria White pupil is a clinical sign that includes all the ocular diseases that become visible with a white pupillary area. Leukocoria can be attributed to different causes: cataract, retinoblastoma, primary hyperplastic vitreous, retinopathy of prematurity, toxocariasis, Coats disease, retinal detachment, vitreous haemorrhage and posterior uveitis. The aim is to use the ocular ultrasound as a tool to treat patients with leukocoria, as it enables to differentiate between the tumour causes (retinoblastoma) and congenital causes (Coats disease).
Universidad Europea de Madrid Centro Adscrito de Valencia
Desmin Ecographer (Optopol Technology) is the ultrasound scanner used. It enables to perform tests in mode A and mode B, both at 12 Mhz. The ultrasound test was performed in a group of patients; children aged 2 to 6 with leukocoria. The examination is performed with the patient seated and head in straight position or supine position; eyelids open or closed. There is no need to use anaesthesia or sedation and before performing the test the patient is given a brief explanation about the ultrasound test. If the patients are children the explanation is given with special emphasis, in case it is necessary the test is repeated in short intervals so not to bother the children.
In Coats disease cases, in mode B ultrasound we see a thin injury of low mobility, with low reflectivity. The ultrasound image is quite variable depending on the state if it is evolutionary or invasive. In the Retinoblastoma cases a malignant tumour on the retina can be seen and it does not usually spread to other tissues.
It is possible to differentiate between two of the Leukocoria causes through ocular ultrasound. In the Coats disease cases ultrasound enables the study of the therapeutic response and further control of the cases treated with cryotherapy or photocoagulation. In the retinoblastomas cases, the tumour can be localized on the retina, so its size is visible in case of a possible surgery.