A young child with type 2 Peters plus syndrome with a history of iridectomy of the right eye was found to have a central opacification of the red reflex during retinoscopy in clinic. Examination under anesthesia revealed a mobile nonadherent retrolental cyst in the vitreous cavity, with an intact view to the fundus (Figure). The child underwent ultrasonography and evaluation by an ocular oncologist, who concluded that the cyst was not consistent with a tumor. Repeated examinations under anesthesia, photography, and ultrasonography revealed no change during 2 years. Red reflex remains intact and visual development continues to progress. Of note, retrolental cysts are not typically associated with anterior segment dysgenesis. If a cyst occurs, one should consider other etiologies such as medulloepithelioma. In the case of an asymptomatic retrolental cyst in a child that is not interfering with visual development, observation may be a viable course of action.
Cavuoto KM, Chang TC. Mobile Retrolental Cyst in a Child With Peters Plus Syndrome. JAMA Ophthalmol. 2016;134(10):e162125. doi:10.1001/jamaophthalmol.2016.2125