Presentation Pattern and Problems in the Management of Retinoblastoma in Benin City, Nigeria

Abstract

Retinoblastoma is the most common intraocular malignancy in children with poor survival rate in developing countries. The aim of this study is to describe the presentation patterns of retinoblastoma and the problems in the management of patients presenting with retinoblastoma in a tertiary hospital in a developing countries. A retrospective study of cases of retinoblastoma at the University of Benin Teaching Hospital in Benin City between January 2003 and December 2012. A total of 37 eyes of 28 patients were studied. There were 14 males and 14 females giving a male to female ratio of 1:1. The age range of the children was between 4 months to 9 years with a mean age of 2.7 +1.85 years (SD). Proptosis was the most common clinical feature seen in 29.7% (n=11eyes). None of the patients presented within 1 month of the onset of symptoms. The problems identified included advanced disease at presentation and late diagnosis. The reasons for late diagnosis among the patients included late  presentation, ignorance of parents, mismanagement in previous hospitals before referral and financial constraint. Four patients defaulted before treatment could be commenced and only one completed his treatment. Challenges faced during the course of treatment included irregular  chemotherapy, not receiving adjuvant chemotherapy, delay in receiving chemotherapy and late surgery. Duration of follow-up ranged from less than one month to 21 months. Managing retinoblastoma has its problems which include late presentation, advanced disease at presentation, abandonment of treatment, financial constraints regarding treatment with chemotherapy and refusal to accept early enucleation as a treatment modality.

Keywords: retinoblastoma, challenges, problems, late presentation