Developmental Delay and School Performance Among Retinoblastoma Survivors: Development/school morbidity among retinoblastoma survivors

Abstract

The purpose of this study was to describe the academic performance of childhood retinoblastoma (RB) survivors. Retrospective cohort study. Retrospective chart review of children followed in a survivorship clinic. A total of 73 patients with RB (median age at diagnosis: 9.97 months; range: 0.29-65.1) were followed for a median of 6.4 years (0.2-1.76). A total of 48 patients (65.8%) had unilateral RB; 43 patients (63.0%) received systemic chemotherapy; and 57 patients (78.1%) underwent enucleation. At last follow-up, 5 children (6.8%) had bilateral visual acuity (VA) <20/70. Seventeen subjects (23.3%) reported school difficulties, and 10 subjects (13.7%) had an individualized education program (IEP). Multivariate analysis revealed that a history of receiving chemotherapy" Multivariate analysis revealed that a history of receiving chemotherapy was associated with self-reported school difficulties (odds ratio [CI]: 5.44; 95% confidence interval [CI]: 1.36-21.69; P=.016), and undergoing an IEP (OR: 11.47; 95% CI: 1.34-98.16; P=.03). The degree of visual impairment and history of enucleation did not influence the risk of self-reported school difficulties or the implementation of an IEP. Among unilateral RB patients, chemotherapy was an independent risk factor for self-reported school difficulties (OR: 12.8; 95% CI: 1.45-113; P=.009) and implementation of an IEP (OR: 15.2; 95% CI: 0.78-292; P=.02). Academic difficulties in childhood RB survivors are associated with chemotherapy treatment, a risk factor independent of VA.