Challenges of managing retinoblastoma in a resource-constrained setting: a 4.5-year retrospective review from Northeastern Nigeria

Abstract Background: Retinoblastoma is the leading intraocular cancer in children, with treatment outcomes significantly poorer in low-resource settings such as Nigeria. This study, conducted at the Federal University of Health Sciences Teaching Hospital, Azare, reviewed the clinical profiles and treatment outcomes of 28 patients diagnosed with retinoblastoma from January 2020 to June 2024. Materials and Methods: It is a hospital-based retrospective study. Ethical approval was secured, and data collected included demographics, symptoms, tumour stage, treatment modalities, and follow-up results. Results: The cohort of patients, aged 0-60 months, had a mean presentation age of 23.8 months, with a male-to-female ratio of 1.3:1. The most common symptom was proptosis, noted in 67.9% of cases, and 25% presented with bilateral disease. The majority, 50%, were classified as Group D in the International Intraocular Retinoblastoma Classification. Alarmingly, treatment abandonment was high, with 75% of patients dropping out after initial presentations. Only 25% proceeded to aggressive treatments like enucleation or modified exenteration. Conclusion: The study highlights critical challenges such as late presentation and high rates of treatment abandonment, paralleling trends in Nigeria and across Africa. To address these issues, increased community awareness, better referral systems, and enhanced psychosocial support are urgently needed to improve management and outcomes for retinoblastoma in these settings.