¡¡¡¡Figure 4Venous phase of the Fluorescein Fundus Angiography (FFA) of the right eye showing double circulation within both the superotemporal mass (A) and the inferior mass (B)£¨ÂÔ£©

¡¡¡¡Based on history, clinical appearance, CT scan and FFA findings, a diagnosis of presumed spontaneously regressed retinoblastoma was made. Enucleation was advised to confirm  the diagnosis and for prosthetic replacement of the right eye, but the patients refused it, and defaulted further followª²up.

¡¡¡¡COMMENT

¡¡¡¡Retinoblastoma can undergo spontaneous regression albeit rare[3]. In this case, spontaneous regression is illustrated by calcification and retinal pigment epithelial changes. The lesion shown in Figure 1 resembles type III regression pattern of a treated retinoblastoma[4]. This entails extensive calcification in a greyish avascular mass.

¡¡¡¡Lens subluxation/dislocation in cases of retinoblastoma has been reported twice in the literature[5,6]. The mechanism thought to be responsible for lens subluxation or dislocation in this condition is disruption of the lens zonular fibres secondary to necrosis of the ciliary epithelium[5].

¡¡¡¡To the best of our knowledge, this is the first reported case of tractional retinal detachment in spontaneously regressed retinoblastoma. This could be attributed to stimulation of an immune reaction to the tumour antigen resulting in panuveitis and neovascularization that resolved into fibrous bands causing the tractional retinal detachment. The presence of band keratopathy supported this postulation. Another possible explanation was the regressed retinal neovascularization, which is a known feature of retinoblastoma.

¡¾²Î¿¼ÎÄÏס¿
  ¡¡1 Mastrangelo D, De Francesco S, Di Leonardo A, Lentini L, Hadjistilianou T. The retinoblastoma paradigm revisited. Med Sci Monit 2008;14(12):RA231ª²240

¡¡¡¡2 Kao LY, Yang ML. Spontaneous regression of retinoblastoma in a Taiwan series. J Pediatr Ophthalmol Strabismus2005;42(4):228ª²232

¡¡¡¡3 Singh AD, Santos CM, Shields CL, Shields JA, Eagle RC Jr. Observations on 17 patients with retinocytoma. Arch Ophthalmol 2000;118(2):199ª²205

¡¡¡¡4 Singh AD, Garwayª²Heath D, Love S, Plowman PN, Kingston JE, Hungerford JL. Relationship of regression pattern to recurrence in retinoblastoma. Br J Ophthalmol1993;77(1):12ª²16

¡¡¡¡5 Kilby AE,Ip MS,Smith ME. Subluxated/dislocated lens and hyphema as features of retinoblastoma. Retina2003;23(6):872ª²874

¡¡¡¡6 Byrnes GA, Shields CL, Shields JA, De Potter P, Eagle RC Jr. Retinoblastoma presenting with spontaneous hyphema and dislocated lens. J Pediatr Ophthalmol Strabismus1993;30(5):334ª²336

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