Retinoblastoma in Singapore: 1976 to 1995

There were at least 56 local and 42 foreign patients seen in Singapore between 1976 and 1995 inclusively. The local incidence rate is 1 in 15789 live-births, and there appears to be no predilection for sex and race. Ninety-eight per cent presented before the age of five with the average age at diagnosis being 18 months. Bilateral cases were diagnosed earlier than unilateral cases. At least 17% are hereditary, with only 2 of these with positive family histories. Of the 41 patients studied for presenting complaints, 82.9% had leukocoria, 19.5% had strabismus and 12.2% had decreased visual acuity. The main mode of treatment was enucleation alone in unilateral disease; in bilateral cases, the main mode was enucleation of the more badly affected eye together with radiotherapy and cryotherapy of the fellow eye. Ninety per cent of all patients who underwent treatment have had enucleation done. Four patients defaulted treatment--with counselling of the parents of these patients, this number could be reduced or at least kept low. Patients with early diagnosis and treatment are more likely to survive. Eight of the 56 patients died. However, with better treatment modalities, the prognosis for both life and vision have, in recent years, improved significantly.