Abstract:
Objectives: To assess the clinical picture and grouping of retinoblastoma at first presentation to the oncology ward at
Muhimbili National Hospital.
Methods: A cross sectional descriptive hospital based study was conducted from April to December 2018. Seventy two
patients who presented for the first time to Muhimbili National Hospital (MNH) with a diagnosis of retinoblastoma were
consecutively sampled and recruited in the study. Visual acuity, horizontal corneal diameter, intraocular pressure,
anterior and posterior segments of the eye were assessed and each eye was classified according to the International
Classification of Retinoblastoma (ICRB) group. Ultrasonography, neuroimaging and histology were performed.
Results: A total of 72 patients comprising of 90 affected eyes were recruited and analyzed: 39(54.2%) males and
33(45.8%) females. Majority of patients were residents of the Coastal and Lake Zones. Family history of Retinoblastoma
was positive in only one patient. Fifty four (75.0%) patients had unilateral disease. Leukocoria (77.8%) and proptosis
(41.7%) were the commonest first clinical signs noted by the family and health workers at MNH respectively. At MNH,
both bilateral and unilateral cases presented with advanced disease of group E and extra ocular extension where
84(93.3%) eyes were indicated for enucleation. The median lag time from disease onset to presentation at MNH was 4
months.
Conclusion: Leukocoria was the commonest first sign of retinoblastoma presentation at home. However, despite early
presentation to primary health facilities, most patients presented to the tertiary centre of MNH late with advanced
disease. Efforts to raise awareness on retinoblastoma to both health workers and the community are important for early
case detection, referral, diagnosis and treatment in order to improve visual outcomes and survival rates of
retinoblastoma patients
