Challenges of retinoblastoma management in a Nigerian tertiary eye care facility

Abstract

Background: Retinoblastoma is the most common intraocular childhood malignancy. Its management is, however, not without challenges especially in a developing country like Nigeria. This study sought to present the clinical profile and treatment outcome of patients with retinoblastoma managed in a Nigerian tertiary eye care facility highlighting the challenges with a view to improving the management of the disease. Materials and Methods: A retrospective, single-institution, and institutional review board-approved review of all patients diagnosed with retinoblastoma between January 2012 and December 2015 was done. Data obtained from case files of patients include demographic characteristics, presenting complaint, laterality of disease, tumor stage using the International Intraocular Retinoblastoma Classification, treatment, and outcome. Information obtained from phone calls to the caregivers were also summarized. Results: The review included 54 eyes of 41 patients between the ages of 2 months and 5 years. The mean age at presentation was 24.4 ± 11.4 months. There were 18 males (43.9%). Duration of symptoms before presentation ranged from 2 weeks to 2 years. Tumor was bilateral in 13 (31.7%) patients. Leukocoria was the most common presenting complaint observed in 32 (59.2%) eyes. Groups D and E were the most common intraocular tumor stage documented in 16 (29.7%) and 15 (27.8%) eyes, respectively. Most patients (29, 70.7%) defaulted from treatment after the first or second presentation. Only 6 (21.4%) of 28 patients offered enucleation or modified exenteration either at presentation (Class E) or after chemoreduction (orbital disease) consented. Conclusion: Late presentation, high default rate, and noncompletion of treatment were the major challenges facing retinoblastoma management in this center.

Keywords

• Challenges
• management
• Nigerian
• retinoblastoma