Pattern and Ocular Trend of Retinoblastoma and Treatment Option in Our Hospital
Objective: The study was conducted to see the pat-tern and ocular trend of Retinoblastoma and treatment option in our hospital.
Study Design: Analytical Descriptive.
Study Population: Patients with Retinoblastoma who visited the Institute of Ophthalmology from 2006 to 2011.
Study Settings: Patients who came to Ophthalmology Department, Mayo Hospital, King Edward Medical University, Lahore. The study plan was approved by ethical committee of King Edward Medical University.
Material and Methods: This was a retrospective des-criptive analytical study. The records of the Institute of Ophthalmology, King Edward Medical University / Mayo hospital, Lahore: Pakistan January 2006- Dec 2011 was analyzed. Five years biopsies (June 2006 to June 2012) of the retinoblastoma, from the Pathology department, ware retrieved to see optic nerve involve-ment in all the retrieved specimens.Results: There were 909 cases of Primary orbital les- ions and out of these 262/909 (29%) lesions were of primary orbital neoplasms. There were 65/262 (36%) cases of malignant neoplasms (62/65:95% case of Retinoblastoma and 3/65:5% cases of melanoma), the remaining 197/262 (64%) cases were benign tumors. There were 52 cases of Retinoblastoma with complete record and their blocks and data were retrieved from the previous record (2007 - 2011) of Ophthalmology and Pathology Department of Mayo Hospital/ King Edward Medical University, Lahore. There were 15 cases of bilateral retinoblastoma and 37 cases with unilateral neoplasms. The age range of bilateral tumors was 2 - 6 years while the range in unilateral tumor was 1 - 10 years. There 32 female and 20 males suffering from Retinoblastoma and male to female ratio was 1:1.5. Male were 38% and females were 61.5%. On clinical examinations, 28 (53.8%) patients presented with proptosis, 20 (38.5%)cases presented with leuco-coria eye was the second most common presenting sign, accounting for about 38.5% of cases), 3 cases (5.8%) with strabismus. Retinoblastoma caused secon-dary changes in the eye, including glaucoma and 1 case (1.9%) presented with sec glaucoma. The clinical findings in all the stages of retinoblastoma were nume-rous and varied. Surgical removal of the tumor was used as a standard management of very unfavorable retinoblastoma cases. Enucleation was performed when there was no chance of preserving useful vision in an eye. It was done in 21/52 (40.4%) cases. Exente-ration was also performed when extension of the tumor into the surrounding areas was considerable. It was performed in 31/52. Cryotherapy was used in bilateral involvement in second eye with small tumors located remote from the disc and macula. It was also used for recurrence after radiation therapy. 6/52 (11.5%) cases were treated with cryotherapy, 5 (9.6%) cases on right side and one case (1.9%) on left side.
Conclusion: The most common pattern of retinoblas-toma was exophytic while the optic nerve and extra ocular involvement was one of the most prognostic factors for distance affecting the treatment. Patients suffering from optic nerve invasion and extra ocular extension or invasion of surrounding tissue with dis-tance metastasis were referred to Oncology Depart-ment.
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