Challenges of Managing Retinoblastoma in a Resource-Constrained Setting.

Abstract

Background: Retinoblastoma is the most common intraocular childhood malignancy. Its management is challenging 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 care facility highlighting the challenges to improve the management of the disease.

Methods: A hospital-based retrospective study and the study received ethical approval from the ethical committee of Federal Medical Center Azare. The Helsinki Declaration was adhered to, and to review of all patients diagnosed with retinoblastoma between January 2020 to June 2024 was done. Data obtained from case files of patients include demographic characteristics, presenting complaint, laterality of disease, tumour stage (using the International Intraocular Retinoblastoma Classification), treatment, and outcome. Information obtained from follow-up was also summarized.

Results: The review included 35 eyes of 28 patients between the ages of 0-60 months. The mean age at presentation was 23.8 ± 7.8 months. There were 16 males (57.1%) and 12 females (42.9%) giving M:F ratio of 1.3:1. Duration of symptoms before presentation ranged from 8 month to 2 years. The tumor was bilateral in 7 (25%) patients. Leukocoria was the most common presenting complaint observed in 19 (67.9%) eyes. Group D was the most common intraocular tumour stage documented in 14 (50.0%). Most patients 21 (75%) defaulted from treatment after the first or second presentation. Only 7 (25%) 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.