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JAMA Ophthalmology Clinical Challenge
September 24, 2020

A Pediatric Patient With an Asymptomatic, Unilateral Retinal Mass

Author Affiliations
  • 1Department of Ophthalmology, University of California, San Francisco, San Francisco
  • 2Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco
JAMA Ophthalmol. 2020;138(11):1211-1212. doi:10.1001/jamaophthalmol.2020.2040

A 4-year-old girl was referred for further evaluation of an asymptomatic, unilateral retinal mass identified by an optometrist on a routine vision screening examination. Her medical history was unremarkable. Her immunizations were up to date, and she had had an uncomplicated prenatal and delivery course. Her ocular history and family history were unremarkable. On examination, the patient’s visual acuity was 20/25 OU and pupillary responses and intraocular pressures were normal. The anterior segments were normal, the lenses were clear, and there was no inflammation in either eye. On a dilated fundus examination, the vitreous was clear bilaterally. A single, superonasal, white retinal mass with no visible calcification or subretinal fluid was present in the right eye (approximately 2.5 disc diameters away from the optic nerve), with associated retinal pigment epithelium changes at the edge of the lesion (Figure 1) and a normal optic disc and posterior pole. The left posterior segment was normal.

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