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G. H. Moore, R. Saiju, MD, U. Shrestha MD, M. K. Shrestha MPH, S. Ruit MD; Retinoblastoma: Geographic Distribution and Presentation at a Tertiary Eye Centre in Kathmandu, Nepal. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4693.
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This study assessed presentation and progression of retinoblastoma at a tertiary eye-care centre in Kathmandu, Nepal. Demographic and geographic distribution, clinical presentation, and treatment method were evaluated.
Retrospective analysis was performed on all patients diagnosed with retinoblastoma at Tilganga Eye Centre from July 2004 to June 2008. Region of residence was recorded during history acquisition. Following retinoblastoma diagnosis, available treatments included enucleation, exenteration, chemotherapy, radiotherapy, cryotherapy, and photocoagulation. Histopathological analysis was performed on enucleated and exenterated specimens.
Thirty patients presented with retinoblastoma during the study period. The mean age at presentation was 2.5 ± 1.6 years (range 5 months to 7 years). Ten of the 12 patients who presented with bilateral retinoblastoma (83%) were from the Terai region of Nepal. The ratio of unilateral to bilateral cases in the Terai region was 1:2. This differed significantly with the ratio in the Hill region (Fisher’s Exact Test, p=0.0012). The mean duration of symptoms before presentation was 2.5± 3.2 months (range 3 days-12 months). 24 patients (80%) presented with leukocoria. Eleven patients (36.6%) presented with leukocoria as their only symptom. 97% of patients underwent enucleation (90%) or exenteration (6.7%) of at least one eye.
A significant correlation exists between region of residence and bilateral retinoblastoma in Nepal. The decreased lag time between onset of symptoms and examination recorded in this study and the increased proportion of patients who reported to TEC with leukocoria, may reflect increased awareness of retinoblastoma amongst primary healthcare workers in Nepal.
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