Hyperreflective vitreous opacities on OCT bilateral retinobl
The present case has been reported in the journal Ophthalmic Surgery, Lasers and Imaging Retina.

An otherwise healthy boy was diagnosed with bilateral retinoblastoma at 3 months of age. Genetic testing revealed a positive Rb1 germline mutation. Examination of the right eye revealed Group A disease with a small tumor (3 mm × 3 mm × 2 mm) (Figure 1A).

The left eye demonstrated Group C disease with a large macular tumor (15×15×6mm) and localized subretinal seeds (Figure 1B). SD-OCT demonstrated a tumor confined to the inner retina with scattered overlying hyperreflective vitreous opacities in the right eye and a large tumor with similar small opacities in the left eye (Figures 1C–1J).

There were no visible vitreous seeds on indirect ophthalmoscopy in either eye. The patient was referred to pediatric oncology for further workup revealing negative MRI of the brain and orbits and lumbar puncture, as well as normal peripheral blood counts.

He is currently undergoing systemic chemotherapy with vincristine, carboplatin, and etoposide for treatment of his retinoblastoma and is planned for close monitoring with repeat examination under anesthesia.

Key takeaway:-
Although the opacities may initially raise concern for potential vitreous seeding, this report suggests alternate potential etiologies for such opacities, which were also seen on imaging of a cohort of normal eyes in pediatric patients.

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