Retinoblastoma

​Most patients with retinoblastoma can be cured, especially if the disease is confined within the eye. If left untreated, the cancer can spread out of the eye and to other parts of the body, where it becomes much harder to treat or may even result in loss of life. Hence, early diagnosis and treatment are important. 

Management of retinoblastoma includes:

1. Routine eye screening (e.g. in children with family history or past history of retinoblastoma)

2. Detailed eye examination for diagnosis of retinoblastoma includes:

• Examination under general anaesthesia
• Digital Imaging of tumour
• Magnetic resonance imaging (MRI) of the brain and eyes.
• Further investigations (bone-marrow aspiration or spinal tap) if there is spread of the cancer beyond the eyeballs
  

3. Treatment depends on a) whether one or both eyes are affected, b) the extent of cancer involvement within the eyeball, or c) whether the tumour has spread beyond the eyeball. Treatment options includes:

• Focal laser or cryotherapy of tumour within eye
• Chemotherapy (systemic intravenous, intra-arterial, intravitreal)
• Radiation therapy
• Enucleation (removal of the eyeball with the tumour within) and orbital implant (usually put in in the same operation to fill the volume left by the missing eyeball)
• Ocular prosthesis
  

4. Cancer genetics – useful in understanding how the condition is inherited and whether there is a risk to other family members and off-springs

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Fundus photos showing retinoblastoma affecting both eyes (top 2 photos, pre-treatment)

Large calcified residual tumour post treatment (bottom 2 photos)

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