Parents’ pics of kids can reveal retinoblastoma

Amateur photographs taken with equipment no more specialized than a digital camera or smartphone can detect retinoblastoma in children’s eyes early in the course of disease.

Researchers from Texas, New York, and Massachusetts found that amateur digital photography can reveal leukocoria, or “white eye,” the cardinal symptom of the intraocular tumor, and that it is visible during the earliest stages of the disease when treatment has the greatest chances of increasing survival and preserving vision.

Experts have known for some time that leukocoria is visible in digital photographs, but they thought it was a late symptom of advanced disease. The latest study dispels that myth.

The investigators used Adobe Photoshop and Microsoft Excel to quantify leukocoria in recreational (nonclinical) baby pictures of 9 children with retinoblastoma. One of the study participants, the child of the researchers, was photographed more than 7,000 times by his parents over a 3-year time period, from birth through diagnosis, treatment, and remission, allowing the researchers to quantify the longitudinal and lateral frequency of leukocoria through the child’s development.

The research shows that leukocoria is evident at a low frequency early in the disease process, and that it increases in frequency as the disease progresses and decreases as the disease regresses. The investigators also found that different types of tumors produce different leukocoric reflections, and that Hue, Saturation, and Value (HSV color space) provide a convenient and effective means for quantifying and classifying pupillary reflections in digital photos.

Although relatively rare, retinoblastoma is the most common primary intraocular tumor in children, affecting annually 10 to 14 youngsters per million children aged 0 to 4 years in the United States, according to the National Cancer Institute.

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