Delhi Journal of Ophthalmology

Association of Clinical Presentations and Histopathological Features of Retinoblastoma in a Tertiary Eye Care Centre, Eastern Nepal

Poonam Lavaju, Badri Prasad Badhu, Sangeeta Shah, Smriti Karki
B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Poonam Lavaju (MD Ophthalmology)
B P Koirala Institute of Health Sciences, Dharan, Nepal
Email id: drpoonamlavaju@yahoo.com


Received: 27-AUG-2019 Accepted: 25-NOV-2019 Published Online: 09-MAY-2020
DOI: https://dx.doi.org/10.7869/djo.524

Abstract
Purpose: To assess an association of retinoblastoma with clinical presentations and histopathological features. 
Materials and Methods: This is a retrospective analysis of clinical and histopathology records of patients admitted with retinoblastoma in a tertiary care center, Eastern Nepal from May 2009 to June 2017.
Results: Forty-four patients were admitted with the diagnosis of retinoblastoma. Age of the patient ranged from four months to nine years with male: female ratio 1.3:1. Unilateral eye was involved in 43 cases (97.7%), leucokoria being the most common presentation (56.8%), followed by proptosis (20.5%). Using the International Intraocular Retinoblastoma Classification, 75.6% were classified as Group E. The cut end of optic nerve invasion (ONI) was seen in 30.2%. According to the International Retinoblastoma Staging Working Group pathology classification, 60% of tumors were Stage PT1. Statistically significant association was seen between longer duration of presentation with leucokoria, neovascularization of iris and uveitis; older age groups with proptosis and leucokoria. Positive predilection was seen between poorly differentiated cell type and older age groups (p-0.052) and proptosis (p-0.02). Advance grade of disease was reflected by delayed presentation (p-0.031) and older age (p-0.05).
Conclusions: Leucokoria was the predominant clinical presentation. Poorly differentiated cell type had positive association with age and proptosis. Advance disease was associated with longer duration and older age.

Keywords :Retinoblastoma, proptosis, leucokoria, intraocular tumor, enucleation