Community Screening and Community Participation Along with Hospital Based Multidisciplinary Treatment Can be the Key Factors for Both Early Detection, Life and Globe Salvage of Retinoblastoma Patients in Developing Countries - Our Experience

Abstract

Each year nearly 8000 new cases of retinoblastoma are detected worldwide. Revolutionary management strategy increased the survival rate of retinoblastoma above 95% but still it is a deadly cancer worldwide. Survival from retinoblastoma depends on income >90% vs 40% (in high to low income countries) and metastases is higher in low-income countries. Forty three percent of global burden lives in 6 countries of Asia. An estimated worldwide death rate is more than 40% and most from Asia and Africa. Bangladesh is one of the developing countries of the South- East Asia region and retinoblastoma constitutes 83% of all pediatric cancer bellow 4 years age group. Early detection of cases and proper referral may decrease the advance disease which may achieved by strong awareness program. To save life and vision multidisciplinary team approach is a time demand now. Chittagong Eye Infirmary is a tertiary eye care center is serving retinoblastoma patients with a multidisciplinary team approach from 2017 and set up chemotherapy facilities in ophthalmic institute. This institute also started screening and local community training program to detect the disease easily and upgraded treatment facility from 2019.From January 2017 to June 2021 total 284 retinoblastoma patients were diagnosed, 104 received chemotherapy and 53 underwent enucleation with long optic nerve. Two hundred fifty six children were screened, 169 primary school teacher and 408 health worker were trained about key sign of retinoblastoma from July 2019 to February 2021. This effort was able to create awareness which showed early presentation of retinoblastoma and seeking treatment of white pupillary reflex than previous period. The hospitals also take care for visual and psycho-social rehabilitation of the retinoblastoma survivals.