|+Differentiating ocular cysticercosis from other ocular lesions
!Disease
!Prominent clinical feature
!Radiological findings
|-
|Ocular cysticercosis
|
* Diagnosis made usually between 8-16 years (rarely in adulthood)
* Wide range of symptoms from being [[asymptomatic]] to [[Decreased visual acuity|decreased vision]] and [[strabismus]].
* [[Decreased visual acuity]] at initial presentation has a poor prognosis. <ref name="urlHow to Diagnose and Manage Coats’ Disease">{{cite web |url=https://www.reviewofophthalmology.com/article/how-to-diagnose-and-manage-coatsand8217-disease-42782 |title=How to Diagnose and Manage Coats’ Disease |format= |work= |accessdate=}}</ref>
|
* [[Fundus (eye)|Fundus examination]] reveals vascular lesions and [[Exudate|exudates]].
* [[Fluorescein angiography]] is the best method to visualize the lesions.
* [[CT]] and [[MRI]] are reserved for atypical cases.<ref name="urlHow to Diagnose and Manage Coats’ Disease">{{cite web |url=https://www.reviewofophthalmology.com/article/how-to-diagnose-and-manage-coatsand8217-disease-42782 |title=How to Diagnose and Manage Coats’ Disease |format= |work= |accessdate=}}</ref>
|-
|[[Retinal detachment]]
|
* Most common presenting symptoms are [[photophobia]] and [[floaters]]
* [[Visual field defect|Visual field defects]] (described as curtain falling from periphery to the center)<ref name="urlManagement of retinal detachment: a guide for non-ophthalmologists">{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2405853/ |title=Management of retinal detachment: a guide for non-ophthalmologists |format= |work= |accessdate=}}</ref>
|
* [[Ophthalmoscope]] is not reliable in detecting retinal detachment as there might be associated [[hemorrhage]]
* [[Ultrasound]] can be used to identify and localize the detachment.<ref name="urlManagement of retinal detachment: a guide for non-ophthalmologists">{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2405853/ |title=Management of retinal detachment: a guide for non-ophthalmologists |format= |work= |accessdate=}}</ref>
|-
|Hyperthyroid Ophthalmopathy
|
* The hallmark is [[Exophthalmos|Eye protrusion]], [[photophobia]], [[lacrimation]] and later in the disease, diminished eye motility.<ref name="urlThyroid Ophthalmopathy - EyeWiki">{{cite web |url=http://eyewiki.aao.org/Thyroid_Ophthalmopathy |title=Thyroid Ophthalmopathy - EyeWiki |format= |work= |accessdate=}}</ref>
* [[CT]]: shows [[inflamed]] muscle and free tendon from [[inflammation]]
* [[MRI]]: shows periorbital fat expansion, increased water content of the muscles as a result of the [[inflammation]].<ref name="urlThyroid Ophthalmopathy - EyeWiki">{{cite web |url=http://eyewiki.aao.org/Thyroid_Ophthalmopathy |title=Thyroid Ophthalmopathy - EyeWiki |format= |work= |accessdate=}}</ref>
|-
|[[Retinoblastoma]]
|
* The most prominent sign is [[leukocoria]], followed by [[strabismus]]
* The patient also may present with [[buphthalmos]], [[Cloudy cornea (patient information)|corneal clouding]] and eye tearing.<ref name="urlc.ymcdn.com">{{cite web |url=https://c.ymcdn.com/sites/www.covd.org/resource/resmgr/VDR_1-1/VDR1-1_article_Kollodge_Web.pdf+ |title=c.ymcdn.com |format= |work= |accessdate=}}</ref>
|
* [[Ultrasound]]: can detect the [[tumor]] as a result of the [[Calcification|calcifications]] inside.
* [[MRI|MRI:]] assess [[Sella turcica|sellar]] and [[Parasellar and suprasellar disorders|parasellar]] regions .. it can also detect extraocular spread of the [[tumor]].<ref name="urlc.ymcdn.com">{{cite web |url=https://c.ymcdn.com/sites/www.covd.org/resource/resmgr/VDR_1-1/VDR1-1_article_Kollodge_Web.pdf+ |title=c.ymcdn.com |format= |work= |accessdate=}}</ref>
|}
{| class="wikitable"
{| class="wikitable"
![[Image:Coats-disease-of-the-eye.jpg|center|300px|thumb|MRI of the orbit showing Coats disease - Case courtesy of Dr Michael Sargent, https://radiopaedia.org/. From the case https://radiopaedia.org/cases/6089]]
![[Image:Coats-disease-of-the-eye.jpg|center|300px|thumb|MRI of the orbit showing Coats disease - Case courtesy of Dr Michael Sargent, https://radiopaedia.org/. From the case https://radiopaedia.org/cases/6089]]
Presence of retinal and/or vitreous traction in approximately all the cases
Presents at any age
Mostly unilateral
Ingestion of larvae leads to the infection
P/E:presence of granuloma and retinal traction
Ultrasound imaging:
Peripheral mass
Vitreoretinal band
Traction retinal detachment
Presence of eosinophils in the anterior chamber tap
Classified into three subtypes:
Macular granuloma
Peripheral granuloma
Endophthalmitis
Hereditary retinal syndrome
Generally causes vitreoretinal traction and ocular inflammation not seen in retinoblastoma
Fundus examination reveals the characteristic signs
Differentiating features of some common and less common differential diagnosis are:
Disease/Condition
Age of presentation
Risk factors
Unilateral/bilateral
Differentiating Signs/Symptoms
Axial length
Imaging findings
Retinoblastoma
< 3 years of age in 90%
Family history
Unilateral/bilateral
Leukocoria
Normal
USG:Intraretinal/subretinal mass with calcification
Congenital Cataract
Presents at birth
Lens opacification rare in retinoblastoma
Fundus examination reveals lens opacification
Ultrasound shows increased echogenicity of lens
Coats disease (exudative retinitis or retinal telangiectasis)
Most cases are unilateral
Mean age at presentation is 6 years
More common in males
Fundus examination: lesion appears more yellow-colored (versus chalky white-gray in retinoblastoma); telangiectatic and aneurysmal retinal vessels are characteristic of Coats disease but uncommon in retinoblastoma
Spectral domain optical coherence tomography may be helpful in distinguishing Coats disease from retinoblastoma
Ophthalmic ultrasound: can be misleading because calcification can also be seen in Coats disease
Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous)
Associated with a micro-ophthalmic eye (a small, malformed eye)
Often associated with a cataract (rare in retinoblastoma)
Congenital (retinoblastoma uncommonly presents at birth)
Dragging of the ciliary processes on exam
Measurement of axial length using fundus examination and ultrasound shows short axial length in persistent fetal vasculature
Retinopathy of prematurity (ROP)
Generally occurs in premature children given high-dose oxygen
Can result in total retinal detachment
Fundus examination: reveals gliotic-appearing retina, which is different from the retinal detachment associated with retinoblastoma
Ocular toxocariasis
Generally causes vitreoretinal traction and ocular inflammation not seen in retinoblastoma
Fundus examination reveals the characteristic signs
↑Butros LJ, Abramson DH, Dunkel IJ (March 2002). "Delayed diagnosis of retinoblastoma: analysis of degree, cause, and potential consequences". Pediatrics. 109 (3): E45. PMID11875173.
↑Sachdeva R, Schoenfield L, Marcotty A, Singh AD (June 2011). "Retinoblastoma with autoinfarction presenting as orbital cellulitis". J AAPOS. 15 (3): 302–4. doi:10.1016/j.jaapos.2011.02.013. PMID21680213.
