Managing Retinoblastoma at a Tertiary Eye Hospital in Kaduna, Nigeria - A Five Year Retrospective Cohort Review

Purpose: To review the outcome of retinoblastoma management at a tertiary eye hospital in Nigeria over a five - year period since chemotherapy became available at our institution.

Methods: A retrospective review of hospital records of patients managed for retinoblastoma between January 2014 and December 2018 was done. Information on age, gender, clinical findings, treatment, duration of follow up and survival as at June 2021. The International Retinoblastoma Classification and Staging Systems were used.

Results: 120 eyes of 94 patients with RB were reviewed. Mean age at presentation was 24.1 ± 11.4 months (range 25 days - 9 years). There were 55 (58.5%) males, 68 (72.3%) had unilateral disease while 17 (18.1%) presented within the first year of life. Leucocoria and proptosis were the most common presenting signs in 53.2% and 40.4% respectively. International Retinoblastoma Stages III and IV disease were seen in 40.4% and 5.3% of patients respectively. Thirty-four patients (36.2%) received a combination of systemic chemotherapy and enucleation while 27 (28.7%) did not receive any treatment. Overall patient survival was 20% while 41% were lost to follow up as at June 2021.

Conclusion: the major challenges encountered in RB management are advanced disease at presentation, difficulties in out-of-pocket financing of treatment, poor follow up and survival. There is an urgent need for a national public screening and treatment programme for this life-threatening condition.