title: Clinical presentation of retinoblastoma in Eastern Nepal.
abstract: BACKGROUND
  The purpose of the present study was to determine modes of presentation of retinoblastoma and the association between proptosis with orbital extension and histopathologically detectable optic nerve infiltration by the tumour.
  
  
  METHODS
  Clinical records and histopathological reports of patients with retinoblastoma were studied retrospectively. The work was undertaken at a tertiary care hospital in eastern Nepal during the period from September 1995 to August 2002.
  
  
  RESULTS
  A total of 43 patients with retinoblastoma were studied. Among them unilateral involvement was found in 39 patients (90.70%) and bilateral involvement in four patients (9.30%). The mean age of presentation was 3.04 +/- 1.80 years (95% confidence interval = 2.49-3.59). The commonest mode of presentation was proptosis with orbital extension in 19 eyes (40.42%) followed by leucokoria in 14 eyes (29.78%). Histopathological reports of 42 eyes (one patient died shortly after admission and did not have an autopsy) confirmed the diagnosis of retinoblastoma and revealed that the optic nerve cut section had been infiltrated in 18, of which 16 had the clinical finding of proptosis with orbital extension. This was statistically significant (relative risk = 21.33, P < 0.001).
  
  
  CONCLUSIONS
  The commonest mode of presentation of retinoblastoma in Nepal is proptosis. Presence of proptosis with orbital extension is associated with optic nerve cut end infiltration by the tumour. The diagnosis or presentation of retinoblastoma in Nepal is delayed and there is tremendous scope for improvement in its management.
authors: Department of Ophthalmology, BP Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal. aabadhu@yahoo.com
authors: Badri
authors: B
authors: Badhu
authors: Shatrughan P
authors: SP
authors: Sah
authors: Sanjay Kd
authors: SK
authors: Thakur
authors: Sunu
authors: S
authors: Dulal
authors: Sandeep
authors: S
authors: Kumar
authors: Archana
authors: A
authors: Sood
authors: Hrishikesh
authors: H
authors: Das
authors: Rabindra P
authors: RP
authors: Sah
mesh_terms: D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005094:Exophthalmos / Q000175:diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009361:Neoplasm Invasiveness; D009390:Nepal / Q000453:epidemiology; D019572:Retinal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012175:Retinoblastoma / Q000453:epidemiology* / Q000473:pathology; D017678:Sex Distribution