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Retinoblastoma (RB) is the most common primary malignant intraocular tumor of childhood presenting usually before 5 years of age. RB in adults older than 20 years is extremely rare. A literature search using PubMed/PubMed Central, Scopus, Google Scholar, EMBASE, and Cochrane databases revealed only 45 cases till date. Over the past decade, there has been a significant increase in the number of such reports, indicating heightened level of suspicion among ophthalmologists. Compared to its pediatric counterpart, adult onset RB poses unique challenges in diagnosis and treatment. This article summarizes available literature on adult onset RB and its clinical and pathologic profile, genetics, association with retinocytoma, diagnostics, treatment, and outcomes.

Purpose:Retinal vascular occlusions affecting both the arterial and venous systems are rare events. Combined branch retinal artery (BRAO) and vein (BRVO) occlusion are exceedingly rare and not well characterized.Methods:Six patients with combined BRAO and BRVO underwent a comprehensive eye examination, fundus fluorescein angiography, optical coherence tomography, and cardiovascular evaluation.Results:Mean age at presentation was 54 ± 7.8 years (range: 39–60), and five of the six were men. Patients had a combination of systemic comorbidities such as diabetes (5), hypertension (4), dyslipidemia (5), and hyperhomocysteinemia (1). All had unilateral combined occlusion characterized by narrowing and cattle tracking of blood in arteries and dilated tortuous veins in the involved quadrant. Fluorescein angiography demonstrated complete capillary drop out and a clear demarcation between the perfused and nonperfused retina. Presenting vision ranged from 6/9 to 1/60 Snellen's, and final vision depended on the macular perfusion status. All eyes were treated with angiography-guided sectoral laser photocoagulation, and three eyes required intravitreal bevacizumab due to macular edema or retinal neovascularization.Conclusions:Combined BRAO and BRVO is rare, may have unique underlying pathogenetic mechanisms, is associated with multiple systemic comorbidities and can yield good visual outcome if macula remains well perfused.

We report a case of polypoidal choroidal vasculopathy (PCV) presented with massive submacular hemorrhage (SMH) and macular hole (MH). Spectral domain optical coherence tomography confirmed the presence of MH along with SMH and also revealed an extrafoveal-notched pigment epithelium detachment (PED) suggestive of PCV. Urgent pneumatic displacement with perfluoropropane (C3F8) was done. Indocyanine green angiography done 3 weeks later showed polyps in the superonasal macula corresponding to PED. Extrafoveal polyps were treated with laser photocoagulation. Inverted flap MH surgery was planned but the patient was lost to follow-up.