Retinoblastoma is the most common malignancy of the eye in early childhood, representing 2 to 2.5 % of all Pediatric cancers. Thanks to advances in surgical techniques -external beam radiation, focal treatment and chemotherapy, the survival rate and preservation of vision have greatly improved. There is no racial or gender predisposition in the incidence of retinoblastoma. Retinoblastoma is bilateral in about 25 to 35% of cases. The average age at diagnosis is 18 months, about 80% of cases are diagnosed by the age of two years. Unilateral (one eye) cases being diagnosed at around 24 months and bilateral (both eyes) cases before 12 months.
Retinoblastoma is the most common intraocular malignancy in children, with a reported crude incidence rate in age group of 0-14 years ranges 3-4 .4 cases per million , which means around 400 new cases per year in Maharashtra region. There is huge need of retinoblastoma clinic as there are only few dedicated centres available all over India to take care of this disease. Most importantly if diagnosed early, it can be cured effectively. Retinoblastoma, is a life threatening childhood eye cancer. If diagnosed and treated early, we can not only save one precious life but also the eye and its vision.
There has been a dramatic change in the overall management of retinoblastoma in the last decade. Specific genetic protocols have been able to make prenatal diagnosis of retinoblastoma. Early diagnosis and advancements in focal therapy have resulted in improved eye and vision salvage. Chemo reduction has become the standard of care for the management of moderately advanced intraocular retinoblastoma. Future holds promise for further advancement in focal therapy and targeted drug delivery. Goals are to create Awareness in rural and semi urban, as well as urban populations regarding, early diagnosis in a Child less than 3 years, and Screening, as well as full diagnosis and management further on if the dreaded disease is identified in them. Since it is a disease of childhood the therapeutic approaches need to consider not only the cure of the disease, but also the need to preserve vision with minimal long term effects.
Infants and Children from 6 months to 4 years of age, for screening and diagnosis of Retinoblastoma will come from rural and semi urban areas from all over Maharashtra. We emphasize that screening of any child for white reflex(cats eye look), Squint, Protrusion of eyeball, should be taken up along the lines of a public campaign, and dilated fundus screening for children should become a standard clinical practice. The impact of a child going blind is enormous as it corresponds to the loss of number of man years of productivity.
We at RFH have a team of specialists, consisting of Pediatric Oncologist, Ophthalmologist, Retina specialist, Radiotherapist, Pathologist, counselor to take care of these patients. There will be multidisciplinary approach to the disease. There is be initial consultation with the ophthalmologist and Pediatric oncologist, and as per case need, further consultation will be done with genetic counsellor and radiation oncologist.