Global Retinoblastoma Study Group , Fabian ID 1 , Abdallah E 2 , Abdullahi SU 3 , Abdulqader RA 4 , Adamou Boubacar S 5 Show all authors , Ademola-Popoola DS 6 , Adio A 7 , Afshar AR 8 , Aggarwal P 9 , Aghaji AE 10 , Ahmad A 11 , Akib MNR 12 , Al Harby L 13 , Al Ani MH 14 , Alakbarova A 15 , Portabella SA 16 , Al-Badri SAF 17 , Alcasabas APA 18 , Al-Dahmash SA 19 , Alejos A 20 , Alemany-Rubio E 21 , Alfa Bio AI 22 , Alfonso Carreras Y 23 , Al-Haddad C 24 , Al-Hussaini HHY 25 , Ali AM 26 , Alia DB 27 , Al-Jadiry MF 17 , Al-Jumaily U 28 , Alkatan HM 19 , All-Eriksson C 29 , Al-Mafrachi AARM 30 , Almeida AA 31 , Alsawidi KM 32 , Al-Shaheen AASM 4 , Al-Shammary EH 33 , Amiruddin PO 34 , Antonino R 35 , Astbury NJ 1 , Atalay HT 36 , Atchaneeyasakul LO 37 , Atsiaya R 38 , Attaseth T 39 , Aung TH 40 , Ayala S 41 , Baizakova B 42 , Balaguer J 43 , Balayeva R 15 , Balwierz W 44 , Barranco H 43 , Bascaran C 1 , Beck Popovic M 45 , Benavides R 46 , Benmiloud S 47 , Bennani Guebessi N 48 , Berete RC 49 , Berry JL 50 , Bhaduri A 51 , Bhat S 52 , Biddulph SJ 53 , Biewald EM 54 , Bobrova N 55 , Boehme M 54 , Boldt HC 56 , Bonanomi MTBC 57 , Bornfeld N 54 , Bouda GC 58 , Bouguila H 59 , Boumedane A 60 , Brennan RC 61 , Brichard BG 62 , Buaboonnam J 37 , Calderón-Sotelo P 63 , Calle Jara DA 64 , Camuglia JE 65 , Cano MR 66 , Capra M 67 , Cassoux N 68 , Castela G 69 , Castillo L 70 , Català-Mora J 71 , Chantada GL 71 , Chaudhry S 72 , Chaugule SS 73 , Chauhan A 74 , Chawla B 75 , Chernodrinska VS 76 , Chiwanga FS 77 , Chuluunbat T 78 , Cieslik K 79 , Cockcroft RL 80 , Comsa C 81 , Correa ZM 82 , Correa Llano MG 71 , Corson TW 83 , Cowan-Lyn KE 84 , Csóka M 85 , Cui X 86 , Da Gama IV 87 , Dangboon W 88 , Das A 89 , Das S 90 , Davanzo JM 91 , Davidson A 92 , De Potter P 62 , Delgado KQ 93 , Demirci H 94 , Desjardins L 95 , Diaz Coronado RY 96 , Dimaras H 97 , Dodgshun AJ 98 , Donaldson C 99 , Donato Macedo CR 100 , Dragomir MD 81 , Du Y 101 , Du Bruyn M 102 , Edison KS 103 , Eka Sutyawan IW 104 , El Kettani A 48 , Elbahi AM 32 , Elder JE 105 , Elgalaly D 106 , Elhaddad AM 106 , Elhassan MMA 107 , Elzembely MM 26 , Essuman VA 108 , Evina TGA 109 , Fadoo Z 110 , Fandiño AC 111 , Faranoush M 112 , Fasina O 113 , Fernández DDPG 114 , Fernández-Teijeiro A 115 , Foster A 1 , Frenkel S 116 , Fu LD 117 , Fuentes-Alabi SL 118 , Gallie BL 97 , Gandiwa M 119 , Garcia JL 120 , García Aldana D 121 , Gassant PY 23 , Geel JA 122 , Ghassemi F 123 , Girón AV 20 , Gizachew Z 124 , Goenz MA 118 , Gold AS 125 , Goldberg-Lavid M 126 , Gole GA 65 , Gomel N 127 , Gonzalez E 128 , Gonzalez Perez G 129 , González-Rodríguez L 21 , Garcia Pacheco HN 130 , Graells J 131 , Green L 132 , Gregersen PA 133 , Grigorovski NDAK 134 , Guedenon KM 135 , Gunasekera DS 136 , Gündüz AK 137 , Gupta H 138 , Gupta S 139 , Hadjistilianou T 140 , Hamel P 141 , Hamid SA 142 , Hamzah N 143 , Hansen ED 144 , Harbour JW 145 , Hartnett ME 144 , Hasanreisoglu M 36 , Hassan S 3 , Hassan S 146 , Hederova S 147 , Hernandez J 148 , Hernandez LMC 93 , Hessissen L 149 , Hordofa DF 150 , Huang LC 151 , Hubbard GB 152 , Hummlen M 153 , Husakova K 147 , Hussein Al-Janabi AN 33 , Ida R 35 , Ilic VR 154 , Jairaj V 155 , Jeeva I 110 , Jenkinson H 156 , Ji X 86 , Jo DH 157 , Johnson KP 158 , Johnson WJ 159 , Jones MM 99 , Kabesha TBA 160 , Kabore RL 58 , Kaliki S 161 , Kalinaki A 162 , Kantar M 163 , Kao LY 164 , Kardava T 165 , Kebudi R 166 , Kepak T 167 , Keren-Froim N 126 , Khan ZJ 168 , Khaqan HA 169 , Khauv P 170 , Kheir WJ 171 , Khetan V 172 , Khodabande A 123 , Khotenashvili Z 165 , Kim JW 50 , Kim JH 173 , Kiratli H 174 , Kivelä TT 175 , Klett A 176 , Komba Palet JEK 177 , Krivaitiene D 178 , Kruger M 179 , Kulvichit K 180 , Kuntorini MW 34 , Kyara A 77 , Lachmann ES 181 , Lam CPS 182 , Lam GC 183 , Larson SA 56 , Latinovic S 184 , Laurenti KD 185 , Le BHA 186 , Lecuona K 187 , Leverant AA 188 , Li C 189 , Limbu B 190 , Long QB 191 , López JP 192 , Lukamba RM 193 , Lumbroso L 95 , Luna-Fineman S 194 , Lutfi D 195 , Lysytsia L 196 , Magrath GN 159 , Mahajan A 197 , Majeed AR 132 , Maka E 85 , Makan M 198 , Makimbetov EK 199 , Manda C 119 , Martín Begue N 16 , Mason L 200 , Mason JO 200 , Matende IO 38 , Materin M 171 , Mattosinho CCDS 134 , Matua M 201 , Mayet I 53 , Mbumba FB 202 , McKenzie JD 105 , Medina-Sanson A 203 , Mehrvar A 204 , Mengesha AA 205 , Menon V 206 , Mercado GJVD 18 , Mets MB 185 , Midena E 207 , Mishra DKC 208 , Mndeme FG 209 , Mohamedani AA 210 , Mohammad MT 211 , Moll AC 212 , Montero MM 213 , Morales RA 63 , Moreira C 214 , Mruthyunjaya P 151 , Msina MS 209 , Msukwa G 119 , Mudaliar SS 138 , Muma KI 215 , Munier FL 216 , Murgoi G 81 , Murray TG 125 , Musa KO 217 , Mushtaq A 11 , Mustak H 187 , Muyen OM 218 , Naidu G 53 , Nair AG 219 , Naumenko L 220 , Ndoye Roth PA 221 , Nency YM 222 , Neroev V 223 , Ngo H 224 , Nieves RM 213 , Nikitovic M 154 , Nkanga ED 225 , Nkumbe H 109 , Nuruddin M 226 , Nyaywa M 227 , Obono-Obiang G 228 , Oguego NC 10 , Olechowski A 79 , Oliver SCN 229 , Osei-Bonsu P 230 , Ossandon D 231 , Paez-Escamilla MA 145 , Pagarra H 12 , Painter SL 156 , Paintsil V 230 , Paiva L 232 , Pal BP 233 , Palanivelu MS 208 , Papyan R 234 , Parrozzani R 207 , Parulekar M 156 , Pascual Morales CR 148 , Paton KE 235 , Pawinska-Wasikowska K 44 , Pe'er J 116 , Peña A 117 , Peric S 236 , Pham CTM 237 , Philbert R 238 , Plager DA 83 , Pochop P 239 , Polania RA 240 , Polyakov VG 241 , Pompe MT 242 , Pons JJ 243 , Prat D 244 , Prom V 172 , Purwanto I 245 , Qadir AO 246 , Qayyum S 11 , Qian J 247 , Rahman A 103 , Rahman S 8 , Rahmat J 143 , Rajkarnikar P 190 , Ramanjulu R 208 , Ramasubramanian A 74 , Ramirez-Ortiz MA 248 , Raobela L 249 , Rashid R 250 , Reddy MA 13 , Reich E 251 , Renner LA 252 , Reynders D 253 , Ribadu D 254 , Riheia MM 255 , Ritter-Sovinz P 256 , Rojanaporn D 39 , Romero L 131 , Roy SR 226 , Saab RH 257 , Saakyan S 223 , Sabhan AH 17 , Sagoo MS 258 , Said AMA 259 , Saiju R 190 , Salas B 260 , San Román Pacheco S 261 , Sánchez GL 262 , Sayalith P 263 , Scanlan TA 77 , Schefler AC 41 , Schoeman J 253 , Sedaghat A 264 , Seregard S 29 , Seth R 265 , Shah AS 128 , Shakoor SA 266 , Sharma MK 267 , Sherief ST 124 , Shetye NG 268 , Shields CL 269 , Siddiqui SN 146 , Sidi Cheikh S 270 , Silva S 69 , Singh AD 91 , Singh N 172 , Singh U 271 , Singha P 88 , Sitorus RS 272 , Skalet AH 273 , Soebagjo HD 195 , Sorochynska T 55 , Ssali G 274 , Stacey AW 275 , Staffieri SE 105 , Stahl ED 276 , Stathopoulos C 216 , Stirn Kranjc B 242 , Stones DK 277 , Strahlendorf C 278 , Suarez MEC 279 , Sultana S 250 , Sun X 280 , Sundy M 273 , Superstein R 141 , Supriyadi E 245 , Surukrattanaskul S 281 , Suzuki S 282 , Svojgr K 283 , Sylla F 284 , Tamamyan G 234 , Tan D 191 , Tandili A 27 , Tarrillo Leiva FF 285 , Tashvighi M 204 , Tateshi B 286 , Tehuteru ES 287 , Teixeira LF 100 , Teh KH 143 , Theophile T 288 , Toledano H 289 , Trang DL 237 , Traoré F 290 , Trichaiyaporn S 281 , Tuncer S 291 , Tyau-Tyau H 292 , Umar AB 3 , Unal E 293 , Uner OE 152 , Urbak SF 294 , Ushakova TL 241 , Usmanov RH 295 , Valeina S 296 , van Hoefen Wijsard M 212 , Varadisai A 180 , Vasquez L 285 , Vaughan LO 84 , Veleva-Krasteva NV 76 , Verma N 139 , Victor AA 272 , Viksnins M 296 , Villacís Chafla EG 64 , Vishnevskia-Dai V 244 , Vora T 268 , Wachtel AE 96 , Wackernagel W 297 , Waddell K 201 , Wade PD 298 , Wali AH 299 , Wang YZ 300 , Weiss A 275 , Wilson MW 301 , Wime ADC 232 , Wiwatwongwana A 302 , Wiwatwongwana D 302 , Wolley Dod C 16 , Wongwai P 303 , Xiang D 304 , Xiao Y 305 , Yam JC 182 , Yang H 306 , Yanga JM 307 , Yaqub MA 308 , Yarovaya VA 309 , Yarovoy AA 309 , Ye H 306 , Yousef YA 211 , Yuliawati P 104 , Zapata López AM 96 , Zein E 310 , Zhang C 311 , Zhang Y 300 , Zhao J 311 , Zheng X 312 , Zhilyaeva K 220 , Zia N 142 , Ziko OAO 259 , Zondervan M 1 , Bowman R 1

Affiliations 

  • 1 International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
  • 2 Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco
  • 3 Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
  • 4 Basra Children's Specialty Hospital, Basra, Iraq
  • 5 National Hospital of Niamey, Niamey, Niger
  • 6 University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria
  • 7 Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
  • 8 University of California, San Francisco
  • 9 Department of Pediatrics, Banaras Hindu University, Varanasi, India
  • 10 Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
  • 11 The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
  • 12 RS Dr Wahidin Sudirohusodo, Makassar, Indonesia
  • 13 The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • 14 Hawler Medical University, Erbil, Iraq
  • 15 Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan
  • 16 Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
  • 17 Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
  • 18 Philippine General Hospital, University of the Philippines, Manila, Philippines
  • 19 College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 20 Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
  • 21 Instituto Cubano de Oftalmología Ramón Pando Ferrer, Marianao, Havana, Cuba
  • 22 University of Parakou, Parakou, Benin
  • 23 St Damien Pediatric Hospital, Port-au-Prince, Haiti
  • 24 Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
  • 25 Pediatric Oncology Department, National Oncology Center, Sana'a, Yemen
  • 26 Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
  • 27 University Hospital Center Mother Theresa, Tirana, Albania
  • 28 Imam Hussein Cancer Center, Karbala, Iraq
  • 29 St Erik Eye Hospital, Stockholn, Sweden
  • 30 Ibn Al Haitham Teaching Eye Hospital, Baghdad, Iraq
  • 31 Beira Central Hospital, Beira, Mozambique
  • 32 Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya
  • 33 Oncology Unit, Child's Central Teaching Hospital, Baghdad, Iraq
  • 34 National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia
  • 35 Bambino Gesù IRCCS Children's Hospital, Rome, Italy
  • 36 Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
  • 37 Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 38 Lighthouse For Christ Eye Centre, Mombasa, Kenya
  • 39 Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 40 Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar
  • 41 Retina Consultants of Houston, Houston, Texas
  • 42 Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
  • 43 Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
  • 44 Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
  • 45 Pediatric Hematology-Oncology Unit, Lausanne University Hospital, Lausanne, Switzerland
  • 46 Hospital Nacional de Niños Dr Carlos Sáenz Herrera, San Jose, Costa Rica
  • 47 Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
  • 48 Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
  • 49 Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire
  • 50 Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
  • 51 The Calcutta Medical Research Institute, Kolkata, India
  • 52 Department of Pediatric Hematology and Oncology, Narayana Health City, Bangalore, India
  • 53 University of the Witwatersrand, Johannesburg, South Africa
  • 54 Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
  • 55 The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine
  • 56 Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
  • 57 Hospital das Clínicas da FMUSP, São Paulo, Brazil
  • 58 Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
  • 59 Institut Hédi Raïs d'Ophtalmologie, Faculté de Médecine, Université Tunis El Manar, Tunis, Tunisia
  • 60 Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
  • 61 Solid Tumor Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
  • 62 Cliniques Universitaires Saint-Luc, Brussel, Belgium
  • 63 Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
  • 64 Hospital del Niño Dr. Francisco De Icaza Bustamante, Guayaquil, Ecuador
  • 65 Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
  • 66 Salud Ocular, Ministerio de Salud Publica, Asuncion, Paraguay
  • 67 Our Lady's Children's Hospital, Dublin, Ireland
  • 68 Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France
  • 69 Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
  • 70 Hospital Pereira Rossell, Montevideo, Uruguay
  • 71 Hospital Sant Joan de Déu, Barcelona, Spain
  • 72 Paediatric Ophthalmology Department, Mayo Hospital and College of Allied Visual Sciences, King Edward Medical University, Lahore, Pakistan
  • 73 Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
  • 74 University of Louisville, Louisville, Kentucky
  • 75 Ocular Oncology Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
  • 76 Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
  • 77 Muhimbili National Hospital, Dar es Salaam, Tanzania
  • 78 National Center for Maternal and Children Health of Mongolia, Ulaanbaatar, Mongolia
  • 79 Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
  • 80 Starship Children's Health, Auckland, New Zealand
  • 81 Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
  • 82 Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, and University of Cincinnati College of Medicine, Cincinnati, Ohio
  • 83 Indiana University Medical Center, Indianapolis
  • 84 Bustamante Hospital for Children, Kingston, Jamaica
  • 85 Semmelweis University, Budapest, Hungary
  • 86 Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • 87 Quelimane Central Hospital, Quelimane, Mozambique
  • 88 Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
  • 89 Department of Pediatric Hematology-Oncology, Tata Medical Center, Kolkata, India
  • 90 Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
  • 91 Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
  • 92 Red Cross War Memorial Children's Hospital and the University of Cape Town, Cape Town, South Africa
  • 93 National Children's Hospital, Panama City, Panama
  • 94 Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor
  • 95 Institut Curie, Paris, France
  • 96 Instituto Nacional de Enfermedades Neoplasicas, Lima, Perú
  • 97 The Hospital for Sick Children, Toronto, Ontario, Canada
  • 98 Department of Paediatrics, University of Otago, Christchurch, Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand
  • 99 The Children's Hospital at Westmead, Sydney, New South Wales, Australia
  • 100 Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil
  • 101 Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
  • 102 University of KwaZulu-Natal, Durban, South Africa
  • 103 Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
  • 104 Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
  • 105 Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
  • 106 Children's Cancer Hospital Egypt 57357, Cairo, Egypt
  • 107 Department of Oncology, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
  • 108 Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
  • 109 Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
  • 110 Aga Khan University, Karachi, Pakistan
  • 111 Hospital Garrahan, Buenos Aires, Argentina
  • 112 Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran
  • 113 Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Nigeria
  • 114 Mi Clinic, Ciudad del Este, Paraguay
  • 115 Hospital Universitario Virgen Macarena, Sevilla, Spain
  • 116 Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
  • 117 Hospital Escuela, Tegucigalpa, Honduras
  • 118 Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
  • 119 Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
  • 120 ClínicaAnglo American, Lima, Perú
  • 121 Servicio Andaluz de Salud, Sevilla, Spain
  • 122 Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
  • 123 Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • 124 Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
  • 125 Murray Ocular Oncology and Retina, Miami, Florida
  • 126 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 127 Department of Ophthalmology, Sourasky Medical Center Tel Aviv, School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 128 Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
  • 129 Hospital Civil de Guadalajara, Guadalajara, Mexico
  • 130 Pediatric Oncology Unit, Instituto Regional de Enfermedades Neoplásicas del Sur, Arequipa, Perú
  • 131 Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
  • 132 IAM NOOR Eye Care Programme, Afghanistan
  • 133 Department of Clinical Genetics and Center for Rare Disorders, Aarhus University Hospital, Aarhus, Denmark
  • 134 National Cancer Institute, Rio de Janeiro, Brazil
  • 135 Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
  • 136 National Cancer Institute, Maharagama, Sri Lanka
  • 137 Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey
  • 138 Bai Jerbai Wadia Hospital for Children, Mumbai, India
  • 139 King George's Medical University, Lucknow, India
  • 140 Retinoblastoma Referral Center, University of Siena, Siena, Italy
  • 141 Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
  • 142 The Indus Hospital, Karachi, Pakistan
  • 143 Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  • 144 John A. Moran Eye Center, University of Utah, Salt Lake City
  • 145 Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • 146 Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  • 147 University Children's Hospital, Bratislava, Slovakia
  • 148 Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
  • 149 Pediatric Hematology and Oncology Center, Mohammed V University, Rabat, Morocco
  • 150 Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
  • 151 Byers Eye Institute, Stanford University, Stanford, California
  • 152 Emory Eye Center, Atlanta, Georgia
  • 153 Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
  • 154 Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • 155 Pacific International Hospital, Port Moresby, Papua New Guinea
  • 156 Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
  • 157 Fight Against Angiogenesis-Related Blindness Laboratory, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
  • 158 Clínica Oftalmológica Pasteur, Santiago, Chile
  • 159 Storm Eye Institute, Medical University of South Carolina, Charleston
  • 160 Bukavu Eye Clinic, Bukavu Official University, Bukavu, Democratic Republic of the Congo
  • 161 Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
  • 162 Department of Ophthalmology, Makerere University College of Health Sciences Kamplala, Uganda
  • 163 Division of Pediatric Oncology, School of Medicine, Ege University, Izmir, Turkey
  • 164 Chang Gung Memorial Hospital, Taipei, Taiwan
  • 165 Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
  • 166 Division of Pediatric Hematology-Oncology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine and Oncology Institute, Istanbul University, Istanbul, Turkey
  • 167 St. Anne's University Hospital Brno, Masaryk University, and International Clinical Research Center/St Anna University Hospital, Brno, Czech Republic
  • 168 Dhaka Medical College Hospital, Dhaka, Bangladesh
  • 169 Department of Ophthalmology, Postgraduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan
  • 170 Angkor Hospital for Children, Krong Siem Reap, Cambodia
  • 171 Duke Eye Center, Duke University Hospital, Durham, North Carolina
  • 172 Sankara Nethralaya, Chennai, India
  • 173 Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
  • 174 Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
  • 175 Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
  • 176 East Tallinn Central Hospital, Tallinn, Estonia
  • 177 Oncologue Pédiatre Responsable d'Unité de Bangui, Bangui, Central African Republic
  • 178 Children's Ophthalmology Department, Children's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
  • 179 Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
  • 180 Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
  • 181 University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • 182 Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
  • 183 Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia
  • 184 Clinical Center of Vojvodina, University Eye Clinic, Eye Research Foundation Vidar-Latinović, Novi Sad, Serbia
  • 185 Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
  • 186 John A. Burns School of Medicine, University of Hawaii, Honolulu, and University of Southern California Roski Eye Institute, Los Angeles
  • 187 Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  • 188 Phoenix Children's Hospital, Phoenix, Arizona
  • 189 Affiliated Hospital of Dali University, Dali City, China
  • 190 Tilganga Institute of Ophthalmology, Kathmandu, Nepal
  • 191 Singapore National Eye Center, Singapore, Singapore
  • 192 Ophthalmology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
  • 193 University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, Democratic Rrepublic of Congo
  • 194 Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora
  • 195 Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
  • 196 Okhmatdyt National Children's Hospital, Kiev, Ukraine
  • 197 Pediatric Hematology-Oncology Unit, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India
  • 198 Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
  • 199 National Center of Oncology and Hematology, Bishkek, Kyrgyzstan
  • 200 University of Alabama at Birmingham, Birmingham
  • 201 Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
  • 202 Scottish Livingstone Hospital, Molepolole, Botswana
  • 203 Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
  • 204 MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
  • 205 Department of Ophthalmology, Jimma University, Jimma, Ethiopia
  • 206 Centre for Sight, New Delhi, India
  • 207 Department of Ophthalmology, University of Padova, Padova, Italy
  • 208 Sankara Eye Hospital, Bangalore, India
  • 209 Kilimanjaro Christian Medical Centre, Moshi, Tanzania
  • 210 Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
  • 211 King Hussein Cancer Center, Amman, Jordan
  • 212 Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands
  • 213 Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic
  • 214 Service d'Oncologie Pédiatrique de l'Hôpital Aristide le Dantec, Dakar, Senegal
  • 215 Ministry of Health, Lusaka, Zambia
  • 216 Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
  • 217 Department of Ophthalmology, Lagos University Teaching Hospital, College of Medicine of the University of Lagos, Lagos, Nigeria
  • 218 Abii Specialists Hospital, Bamenda, Cameroon
  • 219 Aditya Jyot Eye Hospital, Mumbai, India
  • 220 N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus
  • 221 Cheikh Anta Diop University, Le Dantec Hospital, Dakar, Senegal
  • 222 Child Health Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
  • 223 Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
  • 224 Ho Chi Minh Eye Hospital, Ho Chi Minh, Vietnam
  • 225 Department of Ophthalmology, Calabar Children's Eye Center, University of Calabar Teaching Hospital, Calabar Nigeria
  • 226 Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
  • 227 Arthur Davison Children's Hospital, Ndola, Zambia
  • 228 CHU Angondje Cancerologie, Libreville, Gabon
  • 229 Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora
  • 230 Komfo Anokye Teaching Hospital, Kumasi, Ghana
  • 231 Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
  • 232 National Ophthalmological Institute of Angola, Luanda, Angola
  • 233 H M Diwan Eye Foundation, and Tata Medical Center, Kolkata, India
  • 234 Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
  • 235 University of British Columbia, Vancouver, British Columbia, Canada
  • 236 University Hospital Center Zagreb, Zagreb, Croatia
  • 237 Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
  • 238 Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi
  • 239 Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic
  • 240 Fundacion Clinica Valle del Lili, Cali, Colombia
  • 241 Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
  • 242 University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
  • 243 Good Shepherd Hospital, Siteki, Swaziland
  • 244 The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
  • 245 Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
  • 246 Hiwa Cancer Hospital, Sulaymaniyah, Iraq
  • 247 Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
  • 248 Department of Ophthalmology, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico
  • 249 Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
  • 250 Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
  • 251 Department of Ophthalmology, Davidoff Center for Oncology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel
  • 252 School of Medicine and Dentistry, Korle-Bu Teaching Hospital, University of Ghana, Accra, Ghana
  • 253 University of Pretoria, Pretoria, South Africa
  • 254 Federal Medical Center, Yola, Nigeria
  • 255 Nampula Central Hospital, Nampula, Mozambique
  • 256 Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
  • 257 Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
  • 258 NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, United Kingdom
  • 259 Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • 260 Hospital Dr Manuel Ascencio Villarroel, Cochabamba, Bolivia
  • 261 Pediatric Hemato-Oncology, Hospital Universitario Infantil La Paz, Madrid, Spain
  • 262 Hospital Solca Quito, Quito, Ecuador
  • 263 Mahosot Hospital, Vientiane, Laos
  • 264 Department of Ophthalmology, Rasool Akram Hospital, Tehran, Iran
  • 265 Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
  • 266 National Institute of Ophthalmology, Dhaka, Bangladesh
  • 267 East Timor Eye Program, Dili, Timor-Leste
  • 268 Tata Memorial Hospital, Mumbai, India
  • 269 Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
  • 270 Ophthalmology Department, Nouakchott Medical University, Nouakchott, Mauritania
  • 271 Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • 272 Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
  • 273 Casey Eye Institute, Oregon Health & Science University, Portland
  • 274 Mulago National Referral Hospital, Kampala, Uganda
  • 275 Department of Ophthalmology, University of Washington, Seattle
  • 276 Children's Mercy Hospital, Kansas City, Missouri
  • 277 Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa
  • 278 BC Children's Hospital, Vancouver, British Columbia, Canada
  • 279 Pediatra Hemato-Oncologa, Instituto Oncologico del Oriente Boliviano, Santa Cruz de la Sierra, Bolivia
  • 280 Henan Children's Hospital, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China
  • 281 Queen Sirikit National Institute of Child Health, Bangkok, Thailand
  • 282 Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan
  • 283 Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
  • 284 Africa Institute of Tropical Ophthalmology, Bamako, Mali
  • 285 Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
  • 286 University Eye Clinic, Skopje, Macedonia
  • 287 National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
  • 288 Kabgayi Eye Unit, Gitarama, Rwanda
  • 289 Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 290 Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
  • 291 Department of Ophthalmology, Faculty of Medicine, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
  • 292 Université Adam Barka, Abeche, Chad
  • 293 Division of Pediatric Hematology-Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
  • 294 Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
  • 295 National Cancer Center of Uzbekistan, Tashkent, Uzbekistan
  • 296 Children's Clinical University Hospital, Riga, Latvia
  • 297 Department of Ophthalmology, Medical University of Graz, Graz, Austria
  • 298 Jos University Teaching Hospital, Jos, Nigeria
  • 299 National Eye Center Kaduna, Kaduna, Nigeria
  • 300 Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
  • 301 Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee
  • 302 Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand
  • 303 Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • 304 Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
  • 305 Kunming Children's Hospital, Kunming, China
  • 306 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  • 307 Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
  • 308 Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan
  • 309 S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
  • 310 Assistante Hospitalo Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
  • 311 Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
  • 312 Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
JAMA Oncol, 2020 May 01;6(5):685-695.
PMID: 32105305 DOI: 10.1001/jamaoncol.2019.6716

Abstract

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale.

Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis.

Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017.

Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis.

Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]).

Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.