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Updated: Dec 15, 2025
Reconstruct Human Retinoblastoma In Vitro
Published on: October 11, 2022
A ten-year study of Retinoblastoma in Uganda: An approach to improving outcome with limited resources
K Waddell1, M Matua2, C Bidwell2
1Ruharo Eye Centre, Mbarara, Uganda; Mbarara University of Science and Technology, Mbarara, Uganda.
Insights
Early diagnosis and treatment significantly improve survival rates for children with retinoblastoma (RB) in resource-limited settings. Prompt medical attention and accessible treatments are crucial for saving lives and preserving sight in affected children.
Area of Science:
- Pediatric Oncology
- Ophthalmology
- Global Health
Background:
- Childhood cancer survival is poor in resource-limited regions.
- Retinoblastoma (RB) is a common childhood cancer in Africa.
- RB treatment can be managed by non-specialists, improving access.
Purpose of the Study:
- To evaluate survival rates and sight retention in children with retinoblastoma (RB) in a resource-limited setting.
- To identify factors influencing outcomes for pediatric RB patients.
- To inform strategies for improving RB care in under-resourced areas.
Main Methods:
- Prospective follow-up of 665 children with RB over ten years.
- Analysis of survival by RB stage and ocular involvement.
- Assessment of visual acuity and sight retention in bilateral cases.
Main Results:
- Overall five-year survival was 60.2%; 93.3% for Stage 1 unilateral and 87.2% for Stage 1 bilateral RB.
- 18.2% presented with metastatic (Stage 4) RB, with poor survival.
- 70.7% of bilateral RB cases retained some sight post-treatment.
Conclusions:
- Early diagnosis and treatment are critical for good survival prospects in pediatric RB.
- Sight retention is achievable in many bilateral RB cases, supporting education.
- Strategies should focus on community awareness and accessible treatment by general health workers.
Background:
Survival of children with cancer in resource-limited regions is very poor compared to better-resourced regions. Retinoblastoma (RB) is a childhood cancer that is commonly reported in many regions of Africa. RB may be safely and effectively treated by non-specialists, which could facilitate more widespread availability of treatment in under-resourced areas.
Methods:
A ten-year consecutive series of children with RB treated at Ruharo Eye Centre between December 2009 and November 2019 was prospectively followed up. Chemoreduction followed by surgery is the standard approach to therapy. Costs of therapy and also of travel and food are borne by the program which is unaffordable to most families and necessitates donors. Survival by stage of RB and number of eyes affected was described using Kaplan-Meier plots. Visual acuity was assessed for all children with bilateral disease and the retention of sight during follow-up assessed.
Results:
Among 665 children with RB, 18.2 % (121 children) presented with metastatic (Stage 4) RB with only two of these children surviving >24 months. Five-year survival was 60.2 % among all children with RB rising to 93.3 % and 87.2 % for children with unilateral and bilateral Stage 1 disease, respectively. Among 184 children with bilateral disease, 130 (70.7 %) retained some level of sight following primary treatment with 91 of those (49.5 % of all bilateral children) retaining vision up to their death or to the end of follow-up.
Conclusion:
Many children in Uganda present with advanced RB and curative treatment is not possible in this setting. Children diagnosed and treated early have good prospects of survival. Retention of sight among many bilaterally affected children is achievable, facilitating access to normal education. Therefore, the strategic priorities for improving survival are changing community perceptions so that children with eye problems are brought without delay, and widening access to modern treatment by using genereal health workers with standard drugs, backed by financial, social and peer support.
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