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ENUCLEATION TRENDS AND RISK FACTORS OF RETINOBLASTOMA PATIENTS IN MALAYSIA

Vishel S., Sangeetha T., Norhafizah H. & Jamalia R.
abstract
A study was conducted to investigate the clinical presentation of retinoblastoma cases in Malaysia, with a focus on identifying risk factors associated with enucleation. We conducted a cross-sectional analysis of registry data from the National Retinoblastoma Registry spanning from 2004 to 2022. Results based on a cohort of 277 retinoblastoma patients, yield noteworthy insights. The median age at diagnosis was 16 months, with a predilection for unilateral presentation (65%) over bilateral (35%). Gender distribution exhibited no significant bias, with 55.6% males and 44.4% females. Ethnicity-wise, the Malay group demonstrated the highest incidence at 57.0%, followed by Chinese (19.1%) and Indian (7.2%) populations. Leukocoria emerged as the predominant initial symptom, manifesting in 65.4% of cases. Combining leukocoria and strabismus accounted for 12.3% of cases, while strabismus alone was observed in 4.5% of cases. Extraocular extensions, detected radiographically, were noted in 12% of patients, with optic pathway involvement being the most prevalent (3.5% unilaterally and 2.9% bilaterally). Risk factors for enucleation were also examined, revealing that unilateral cases carried a significantly higher enucleation risk (10.48 times) compared to bilateral cases. A family history of retinoblastoma was associated with a noteworthy 89% reduction in enucleation risk. Additionally, advanced International Intraocular Retinoblastoma Classification (IIRC) stages D and E correlated with an elevated likelihood of enucleation. In conclusion, our study underscores the importance of early detection, particularly in unilateral cases and advanced stages of retinoblastoma. These findings hold significant clinical relevance and can inform more informed clinical decision-making and patient counselling.
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