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All Journal Folia Medica Indonesiana Biomolecular and Health Science Journal Majalah Biomorfologi (Biomorphology Journal) CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Vision Science and Eye Health Journal Ophthalmologica Indonesiana
Lutfi, Delfitri
Division Of Orbital Ophthalmic Oncology, Department Of Ophthalmology, Faculty Of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Subconjunctival Hemorrhage as a Sign of Intraocular Retinoblastoma Progression to Orbital Retinoblastoma Jatikusuma, Anas; Lutfi, Delfitri; Cahyadi, Andi; Heriyawati
Vision Science and Eye Health Journal Vol. 4 No. 3 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i3.2025.95-99

Abstract

Introduction: Retinoblastoma is the most common intraocular malignancy of childhood. While treatable when detected early, a delayed diagnosis can lead to orbital extension, which significantly worsens the prognosis. We report an unusual case in which a subconjunctival hemorrhage signaled the progression of intraocular retinoblastoma to orbital involvement. Case Presentation: A 2-year-4-month-old child presented with a one-month history of left-eye leukocoria. Ocular ultrasound and computed tomography (CT) confirmed features of an intraocular retinoblastoma (Group E), and urgent enucleation was planned. The surgery was delayed by two months; shortly before the operation, the child developed an inferonasal subconjunctival hemorrhage that rapidly expanded. During enucleation, a reddish-brown extrascleral tumor was discovered beneath the hemorrhage, indicating orbital extension. Histopathology revealed Grade 3 retinoblastoma with optic nerve invasion (resection margin free of tumor). Adjuvant chemotherapy was initiated postoperatively. Conclusion: Subconjunctival hemorrhage can be an unusual warning sign of orbital tumor extension in retinoblastoma. This case highlights the importance of raising awareness and reducing diagnostic delays, particularly in resource-constrained settings.
Co-Authors Alphania Rahniayu Amelia Rahmah Kartika Andi Cahyadi Ervianti, Octarina Fitria Kusumastuti Hasna Shahida Amatlulloh Hendrian Dwikoloso Soebagjo Heriyawati Hermawan Susanto Hermina Novida, Hermina Jatikusuma, Anas Linda Dewanti Luki Indriaswati Lutfiyah, Zahirah Siti Made Angga Putra Maria Debora Niken Larasati Muhammad Fariz Muhammad Valeri Alhakiim Nandang Sudrajat Nurlistyani, Dinda Puspita Prastyani, Reni Rifat Nurfahri Rizki Adrian Hakim Soelistijo, Soebagijo Adi Stella Agatha Widjaja Stepanus Massora Susy Fatmariyanti SUTJIPTO Zuhria, Ismi