Retinoblastoma in Hong Kong from 2008 to 2019: looking back and moving forward

Purpose: To report the incidence, clinical features, and treatment outcomes of retinoblastoma at a tertiary referral center in Hong Kong. Methods: Medical records of all patients with retinoblastoma presenting to Hong Kong Eye Hospital from 2008 to 2019 were reviewed. Results: 75 eyes in 55 patients were treated for retinoblastoma during the 10-year study period. The mean age at presentation was 19.8±16.4 months. The mean duration of symptoms before diagnosis was 1.1±2.1 months. The most common presenting sign was leukocoria and/or strabismus (n=33, 60.1%). 65% of patients presented with advanced disease of groups D and E. The tumor was unilateral (n=35, 63.6%), bilateral (n=18, 32.7%), or trilateral (n=2, 3.6%). The enucleation rate was 0% in groups A to C, 70% in group D, and 93.3% in group E. With the introduction of intra-arterial chemotherapy since 2016, the globe salvage rate has increased from 29.4% to 33.3% in group D eyes and from 4.5% to 12.5% in group E eyes. The overall globe salvage rate was 40.0%, and the overall 5-year survival rate was 100%. Conclusions: The prognosis of retinoblastoma is good in cases with early detection and appropriate treatment. Unfortunately, most patients presented with relatively advanced disease, which lowers the overall globe salvage rate. There is a need for enhanced public awareness and education for healthcare professionals to facilitate early detection and improve ocular outcomes for children with retinoblastoma.