A PEDIATRIC ophthalmologist (C.J.K.) performed biweekly examinations
on dizygotic twins born at 26 weeks' gestation to survey for retinopathy of
prematurity. There was no family history of retinoblastoma or other eye diseases.
Twin A, a male, developed threshold disease and underwent laser treatment.
Twin B, a female, had disease that regressed without the need for laser intervention.
At 3 months of age, the pediatric ophthalmologist found twin B to have a solid
elevation in the macula of 3 to 4 disc diameters in the right eye. This lesion
had not been noted on examination 2 weeks earlier. A B-scan by a retina specialist
(M.S.R.) detected elevation with a possible calcific component. On referral
to a retinoblastoma specialist (D.H.A.), the infant was confirmed to have
one retinoblastoma centered directly in the fovea. The horizontal diameter
of the lesion was 3.94 mm; the vertical diameter, 3.39 mm; the height, 2.0
mm; and the distance from the edge of the tumor base to the edge of the optic
disc, 2.2 mm. The area of the tumor base was 11.1 mm2 and was computer
calculated based on digital fundus photography (Figure 1). The infant underwent placement of a radioactive ruthenium
plaque 13 days after the examination in the retinoblastoma clinic. On fundoscopic
examination under anesthesia in the operating room before placement of the
plaque, the tumor was measured again. The horizontal diameter was 5.1 mm;
the vertical diameter,4.33 mm; the height, 2.0 mm; and the distance from the
edge of the tumor base to the edge of the optic disc, 1.84 mm. The area of
the tumor base was now 18.1 mm2 (Figure 2).
Abramson DH, Schefler AC, Beaverson KL, Rollins IS, Ruddat MS, Kelly CJ. Rapid Growth of Retinoblastoma in a Premature Twin. Arch Ophthalmol. 2002;120(9):1232-1233. doi:10.1001/archopht.120.9.1232