Tumores oculares pediátricos retinianos y no retinianos: avances en el diagnóstico clínico y la caracterización por imágenes
Palabras clave:
retinoblastoma; neoplasias oculares; niño; ultrasonografía; tomografía de coherencia óptica; resonancia magnética; pseudorretinoblastomaResumen
DOI: https://doi.org/10.46296/gt.v9i18.0407
Resumen
Los tumores oculares pediátricos comprenden neoplasias retinianas, uveales y del segmento anterior, cuyo diagnóstico exige diferenciarlas de lesiones simuladoras. Esta revisión de alcance sintetizó los avances en diagnóstico clínico e imagen para la caracterización, estadificación y seguimiento de estas entidades. Se consultaron PubMed, Literatura Latinoamericana y del Caribe en Ciencias de la Salud y Scientific Electronic Library Online para el periodo comprendido entre enero de 2000 y el 2 de agosto de 2026. De 2.048 registros iniciales se eliminaron 197 duplicados; 1.851 registros únicos se sometieron al proceso de selección, se evaluaron 112 publicaciones y se incluyeron 62. El retinoblastoma concentró la mayor parte de la evidencia. El examen del fondo de ojo constituye la referencia clínica; la ecografía permite identificar masas y calcificaciones; la tomografía de coherencia óptica portátil contribuye a caracterizar lesiones pequeñas y orientar el seguimiento; y la resonancia magnética de alta resolución resulta esencial para evaluar el nervio óptico y la extensión ocular, orbitaria e intracraneal, aunque un estudio negativo no excluye invasión microscópica. La biomicroscopia ultrasónica es especialmente útil en el meduloepitelioma. La enfermedad de Coats, la persistencia de la vasculatura fetal y la toxocariasis requieren interpretación clínica y multimodal. La inteligencia artificial y la radiómica muestran resultados prometedores en estudios retrospectivos, con validación externa insuficiente. El diagnóstico debe integrar anatomía, contexto clínico y modalidades complementarias. La tomografía computarizada no se recomienda de rutina cuando se dispone de ecografía y resonancia magnética. Se necesitan protocolos multicéntricos, validación externa y mayor representación de entornos con recursos limitados.
Palabras claves: retinoblastoma; neoplasias oculares; niño; ultrasonografía; tomografía de coherencia óptica; resonancia magnética; pseudorretinoblastoma.
Abstract
Pediatric ocular tumors comprise retinal, uveal, and anterior segment neoplasms that must be distinguished from mimicking lesions. This scoping review synthesized advances in clinical diagnosis and imaging for lesion characterization, staging, and follow-up. PubMed, Latin American and Caribbean Health Sciences Literature, and Scientific Electronic Library Online were searched for publications from January 2000 through August 2, 2026. Of 2,048 initial records, 197 duplicates were removed; 1,851 unique records underwent selection, 112 reports were assessed, and 62 were included. Retinoblastoma accounted for most of the evidence. Fundus examination remains the clinical reference; ultrasonography identifies masses and calcification; handheld optical coherence tomography supports the characterization of small lesions and follow-up decisions; and high-resolution magnetic resonance imaging is essential for evaluating the optic nerve and ocular, orbital, and intracranial extension, although a negative study does not exclude microscopic invasion. Ultrasound biomicroscopy is particularly useful for medulloepithelioma. Coats disease, persistent fetal vasculature, and ocular toxocariasis require clinical and multimodal interpretation. Artificial intelligence and radiomics show promising results in retrospective studies but lack sufficient external validation. Diagnosis should integrate anatomy, clinical context, and complementary imaging modalities. Computed tomography is not recommended routinely when ultrasonography and magnetic resonance imaging are available. Multicenter protocols, external validation, and greater representation of resource-limited settings are needed.
Keywords: retinoblastoma; ocular neoplasms; child; ultrasonography; optical coherence tomography; magnetic resonance imaging; pseudoretinoblastoma.
Información del manuscrito:
Fecha de recepción: 14 de julio de 2026.
Fecha de aceptación: 10 de septiembre de 2026.
Fecha de publicación: 28 de octubre de 2026.
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