The Prevalence of Refractive Errors Among Children With Cured Retinoblastoma

To study the prevalence of refractive errors among children with cured retinoblastoma in the context of clinical variables.

A cross-sectional study was conducted in the Ophthalmology Department at Ain Shams University Hospital from September 2023 to April 2024. Cycloplegic refraction and fundus photography were performed for children with cured retinoblastoma coming to the ocular oncology clinic for follow-up.

Refractive errors were studied in 49 children with cured retinoblastoma, aged 3.8 to 18 years. Refractive astigmatism was the most common error affecting 44.1% of retinoblastoma eyes (95% CI: 27% to 62%) followed by hypermetropia in 26.4%, (95% CI: 11% to 42%). Anisometropia of 1.00 diopter or greater existed in 53.8% of children with retinoblastoma (95% CI: 26% to 91%). Amblyopia due to uncorrected refractive errors existed in 28.6% of children (95% CI: 15% to 42%). A significant positive association existed between the amount of refractive astigmatism and the number of tumors per eye (r = 0.583; P < .001), the number of quadrants affected by the disease (r = 0.472; P = .005), the number of systemic chemotherapy sessions (r = 0.401; P = .028), the number of laser sessions (r = 0.489, P = .004), and the number of globe salvage modalities (r = 0.46 and P = .006). A significant negative association existed between the amount of refractive astigmatism and the posterior tumor margin to disc distance (r = -0.412; P = .015).

Refractive errors are common among children with retinoblastoma, with astigmatism being the most common. Uncorrected refractive errors constitute a risk factor for amblyopia in children with cured retinoblastoma. Diffuse multifocal disease, tumors nearer to the disc, longer chemotherapy duration, and more intensified local treatment are associated with higher refractive astigmatism.