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Clinical misdiagnosis decreasing in pediatric enucleation cases, but risk still exists
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ORLANDO, Fla. — Ophthalmologists should convey the remote possibility of a potential clinical misdiagnosis in uncertain pediatric enucleation cases during the consent process to alert patients and their families to the risk.
"Fortunately, the misdiagnosis rate has decreased over time," Tina Rutar, MD, said at the American Association for Pediatric Ophthalmology and Strabismus meeting here. "We attribute that to improved diagnosis."
In the oculoplastics paper session at the meeting, Dr. Rutar presented results of a study that examined pathology reports of pediatric enucleation cases from 1960 to 2008. Subjects were between the ages of 0 and 18 years. Cases with differing clinical and pathologic diagnoses were examined.
Of 746 eyes of 729 pediatric patients that underwent enucleation, 30 eyes (4%) of 29 patients had discordant clinical and pathological diagnoses. According to the study's findings, of the 362 patients who had enucleation for clinically suspected malignancies, 21 (5.8%) were misdiagnosed. Of the 367 patients who underwent enucleation for suspected benign clinical indications, seven (1.9%) had "intraocular malignancies by histopathology."
Misdiagnosis decreased by decade, with the highest rate, 6.5%, occurring in the 1960s. No misdiagnosis occurred from 1990 to 2008, the study found.
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