title: Presentation of retinoblastoma at a paediatric eye clinic in ghana.
abstract: BACKGROUND
  Retinobalstoma, the commonest childhood malignant intraocular tumour, is usually diagnosed early with over 90% survival rate in developed countries. In developing countries, the diagnosis is late resulting in less than 50% survival.
  
  
  OBJECTIVE
  To determine retinoblastoma stages at presentation and patients' outcomes.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  The clinical and histopathological records of children with retinoblastoma seen from May 2004 to December 2005 were studied. Data was analysed for mode of presentation, laterality, clinical staging using Reese-Ellsworth (R-E) classification, histopathological high risk features (HHRF) for metastasis, and patient outcome.
  
  
  METHODS
  Ophthalmology Unit, Korle-Bu Teaching Hospital, Ghana.
  
  
  RESULTS
  Twenty-three patients presented with retinoblastoma over the period. Males were 12(52.2%). The age range from 1 to 84 months, mean 36.3(±22.15) and median (36 months). Nineteen (82.6%) had unilateral and 4(17.4%) bilateral disease. The common clinical presentations were leukocoria in 20(87.0%), proptosis 8(34.8%), strabismus 5(21.7%) and red eye 5(21.7%). The clinical features were commensurate with R-E stage V in 20(87.0%) patients, 2(8.7%) with orbital recurrence and 1(4.3%) with post-enucleation anophthalmos. HHRFs were present in 9(75%) enucleated eyes with invasion of optic nerve as the commonest site (7/9). The patients were followed up for 1 day to 19 months. Eight abandoned treatment, 2 were discharged for palliative treatment, 2 out of 5 with metastasis died and 6 had no metastases at their last visit. Common sites for metastasis were the bone marrow, brain and orbit.
  
  
  CONCLUSIONS
  Majority of the patients presented with advanced disease manifesting as leukocoria, proptosis, RE stages V disease and poor outcome.
authors.affiliation: Ophthalmology Unit, Department of Surgery, University of Ghana Medical School, PO Box 4236, Accra, Ghana.
authors.forename: V
authors.initials: V
authors.lastname: Essuman
authors.forename: C T
authors.initials: CT
authors.lastname: Ntim-Amponsah
authors.forename: S
authors.initials: S
authors.lastname: Akafo
authors.forename: L
authors.initials: L
authors.lastname: Renner
authors.forename: L
authors.initials: L
authors.lastname: Edusei