Subconjunctival indocyanine green identifies lymphatic vessels.

vitreous cavity. Strong glial fibrillary acidic protein positivity confirms the diagnosis. Thickening of the vessel walls, perivascular pigment, intralesional cysts, and calcareous deposits (calcospherites) are also detectable. Massive retinal gliosis is characteristically encountered in phthisical eyes after trauma, surgery, or inflammation and in other conditions such as retinopathy of prematurity or Coats disease.3 Our patient’s MRG was probably a poorly modulated reparative response to an unexplained preceding hemorrhage in the eye. The smaller retinal vasoproliferative tumors are also seen in such settings, implying that they too are usually reactive.5,6Wedoubt there is any intrinsic retinal property inNF1 that is conducive toMRG.StudiesofMRGhavepreliminarily shown polyclonality, further supporting a reactive lesion.3 Immunostains forp53andKi-67hereare close tonegative, whereas they are positive (>10% of cells) in astrocytic neoplasms.6Retinoblastomas canbedistinguished fromMRG with imaging studies by virtue of the former’s more prominent calcifications, frommedulloepitheliomas that have ciliary region cysts, and from pediatric melanomas, which preferentially arise in the anterior segment of the eye.