RETINOBLASTOMA: RETROSPECTIVE STUDY OF 18 CASES .

Retinoblastoma is a malignant intraocular tumor affecting mainly infants and children especially under 5 years old. It is a disease involving both the functional and the vital prognosis. The involvement is either unilateral or bialteral. The diagnosis of retinoblastoma is essentially clinical and is currently being improved following developments in medical imaging and its contribution. Its management is multidisciplinary and requires urgent intervention in a specialized environment. The therapeutic aspect has progressed in recent years.We report through our study the  epidemiological and  clinical aspect of retinoblastoma and we discuss its therapeutic management .

ophtalmology B Departement , Speciality hospital of ibn sina ,Rabat ,Morocco .

It's a  retrospective study , a series of 18 patients collected in the ophtalmology B departments at the hospital of specialities in Rabat  between January 2018 and september 2021.

In our study the average incidence corresponded to 4.5 cases per year, the average age of diagnosis was 26  months with a clear male predominance (75%), the notion of consanguinity was reported in 20.7% cases. A history of a monophtalmic father and brother who died from retinoblastoma was reported in a single patient . The disease was unilateral in 88.88% of cases and bilateral in 11.11% of cases. The most frequent reason for consultation was leukocoria associated with other symptoms (41%), followed by strabismus (11%) and exophtalmos (11%).  The diagnosis was made after ophtalmologic examination under general anesthesia combined with the radiologic data. The endophytic form of retinoblastoma represented 76.74% of cases; however 23.25% corresponded to exophytic forms. The optic nerve invasion in 5.5% of cases, and choroid in 35.29% of cases, Therapeutically, In all admitted patients, neoadjuvant chemotherapy was performed , enucleation was necessary in most cases (96.01%), The thermo-chemotherapy in 2 patients with bilateral retinoblastoma. Follow-up varie between 2months and 48months; Exposure of the ball was noted in 1 patient and only one case of death in a patient who had bilateral retinoblastoma despite an enuclation of the 2^nd eye and adjuvant radiochimiotherapy .

The management of retinoblastoma is multidisciplinary and must be as early as possible, it involves surgery, chemotherapy, which has evolved a lot in recent years, radiotherapy and especially focal therapies such as thermotherapy, thermo-chemotherapy, cryotherapy , brachytherapy, and gene therapy. The goal of the therapist is therefore the survival of the patient, the preservation of his visual function, and the improvement of the aesthetic appearance by the placement of an ocular prosthesis in the operated patients.