Challenges in the Management of Retinoblastoma during Nationwide Lockdown: An Observational Study from a Retinoblastoma Center in South India

Abstract

Abstract Introduction The nationwide lockdown due to coronavirus disease 2019 led to travel restrictions resulting in a delay in diagnosis, treatment, and follow-up of children with retinoblastoma (RB). Objectives We audited the impact and challenges of lockdown among RB children over 1-year period (May 2020–2021). Materials and Methods It is a cross-sectional study of 104 children with RB, who presented within the 1-year study period. The demographic details, clinical presentations, and outcome of treatment due to lockdown were studied. Results Of the 152 eyes of 104 children, unilateral RB was observed in 52% and bilateral in 48%, in which four children had metastatic disease and one child had trilateral RB. International classification groups D (n = 64 eyes, 42%) and E (n = 38 eyes, 25%) were in majority. Almost, half of the children (n = 53, 51%) underwent enucleation. Overall, the vision was preserved in 32% of the children and globe preservation in 49% of children. Eleven children (10.5%) succumbed due to disease progression. But, only five children were affected with severe acute respiratory syndrome coronavirus 2 infection. The majority of children (n = 72, 69%) had to travel more than or equal to 1,000 km for treatment. About 57% (n = 60) patients were newly diagnosed during the lockdown period and due to the travel restrictions, they had a mean delay of 2.2 months (range: 0–15 months) in starting treatment and 27% (n = 29) of children on treatment had an interruption of treatment. Conclusion Multidisciplinary team management with strategies to support the RB families during locked down crisis is essential to continue care without interruptions.