Retinoblastoma in Two Decades of Ramathibodi

Skowrat Kunavisarut M.D*
Somporn Suwimolsatian M.D*
Laksana Pochanugool M.D**
Pongjan Hathirat M.D*** 
*Department of Ophthalmology,
** Department of Radiology,
*** Department of Pediatrics, Ramathibodi Hospital, Mahidol University

ABSTRACT We reviewed the records of retinoblastoma patients in the Department of Ophthal mology, Ramathibodi Hospital during 1970 to 1992. There were 193 cases (106 males and 87 females), 58 cases (30%) were bilateral. The mean age at diagnosis in bilateral cases was 27.48 + - 16.37 months. The mean age at diagnosis of the unilateral cases was 34.89 + - 23.82 months. In unilateral cases, the frequency of right or left eye involvement was not significantly different. 30.5% of cases were from north-eastern Thailand. Positive family history was founnd in 3.6%. The most common presentation was leucocoria (51.79%).

Malignant cells in CSF were found in 20.7% of bilateral cases, and 16.20% of unilateral cases. Bone marrow study was positive in 31.91% and 28.3% respectively. Most patients were treated by enucleation followed by radiation and chemotherapy. Some cases received cryotherapy or photocoagulation in the second eyes. Second malignancy, osteosarcoma developed in 3 cases. There was one case which the tumor showed spontaneous regression.

Of the 135 unilateral cases, 17.04% died within five years and 28.5% survived longer than five years. Of the bilateral cases, 6.7% died within five years, and 24.14% survived longer than five years. The rest were cases whose follow up period less than five years and some who lost follow up.