Dilemma in Management of Retinoblastoma

Abstract

Retinoblastoma, although rare, is the most common intraocular malignancy in children. Early detection plays an important role in the management of retinoblastoma because it greatly affects the prognosis. But unfortunately, this was difficult to done in a developing country with a low socioeconomic level population. This study aims to describe the profile of retinoblastoma in Dr. M. Djamil Hospital Padang, Indonesia from 2003 until 2012 and to shows the relationship between socioeconomic factors with the management of retinoblastoma. Data were obtained from medical records of patients during the period of January 2003 until December 2012 include of age, sex, diagnose, management, ocular presentations, subjected eye, socioeconomic circumstances and patients parent knowledge about retinoblastoma. There were 99 retinoblastoma patients in this period, 56 (56.56%) male patients and 43 (43.44%) female patients. The most common range of age was 3-4 years as many as 40 patients (40.40%). Unilateral involvement present in 76 patients (76.76%) and 23 patients with bilateral involvement (23.24%). Protusio is the most common ocular presentation as much as 65.66% (65 patients). Combination of exenteration and chemotherapy was the most common management which performed on 32 patients (32.32%). The most common reason which caused delayed to seek treatment due to financial problem (42.42%) followed by lack of information about the complication of the disease (35.35%). Both of these factors had become a dilemma and a problem for us because on one hand we are trying to detect the disease as soon as possible while in terms of financial and socioeconomic factors do not support the patient's family.