Keywords
Maputo Central Hospital (MCH)
Modalities of management
Eligible
How to Cite
Abstract
Background: Retinoblastoma is the commonest intraocular malignancy in childhood. The national
epidemiological characteristics of retinoblastoma in Mozambique are not clearly known. Early diagnosis
and appropriate treatment leads to a favourable outcome while a delayed diagnosis and inappropriate
treatment can be fatal.
Objective: To determine the pattern of presentation and management of retinoblastoma patients at
Maputo Central Hospital during a 5 year period (1st January 2010 to 31st December 2014).
Methodology: The study was a retrospective case series carried out at Maputo Central Hospital
(Ophthalmology and Paediatric Oncology Services). Records of all retinoblastoma patients were retrieved
with the help of the specific file number. Demographic characteristics, clinical presentation, investigations
and management modalities of retinoblastoma patients were retrieved. Data was extracted and entered
into a structured questionnaire and analysed.
Results: A total of 57 patients from 7 different provinces of Mozambique had clinical, histological or both
clinical and histological diagnosis of retinoblastoma. The overall mean age at presentation was 30.5 months
(CI 24.65 - 36.05) (SD 21.5); 82.4% of cases had unilateral retinoblastoma while 12.3% of cases had bilateral
(mean age at presentation was 30.2 months and 26.4 months respectively). The female: male ratio was
1.2:1. The main presenting complaint was white reflex (62.5%) followed by eye swelling (50%), eye redness
(40%) and poor vision (32.5%) while the main clinical signs were leukocoria (55%) followed by proptosis
(50%) and eye redness (27.5%). Out of the 51 eyes who had surgery: 96% did not have documentation
of the choroid and 98% of the scleral, but 54.9% of the eyes had optic nerve involovement, 33.3% had
resection margin involvement and 31.4% had periocular tissue involvement. The main modalities of
management were enucleation (93.9%), chemotherapy (24.5%) and exenteration (18%). The eligible
patients for chemotherapy were 67.7% but only 35.3% of the patients received chemotherapy.
Conclusion: Many patients presented at older ages (with a mean age at presentation of 30.5 months) and
many presented late with advanced orbital disease. Majority of the patients had unilateral retinoblastoma.
Significant number of patients had optic nerve, resection margin and periocular tissue involvement noted
on histology. The main modalities of management were enucleation, exenteration and chemotherapy,
although there were no clear eligibility criteria for chemotherapy in retinoblastoma patients.
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