PATTERN OF PRESENTATION OF ORBITO-OCULAR TUMORS IN UNIVERSITY COLLEGE HOSPITAL(UCH), IBADAN

Abstract

Orbito-ocular tumors are stereotypic, monotonous new growth of the tissues in the orbito-ocular region, made up of the orbit, eyeball and extra-orbital anatomic areas. Orbito-ocular tumors are reported to be more common in tropical Africa than in other parts of the world. Orbito-ocular tumors are of great public health importance and the challenges facing the patients include cosmetic deficits, visual loss, and threat to life. There is relative paucity of information on the prevalence of the different types of orbito-ocular tumors and treatment outcome in Nigerian patients. This study thus aims to determine the pattern of presentation of patients with histologically confirmed orbito-ocular tumors seen at University College Hospital (UCH), Ibadan, between January 1990 and December 2009. This was a retrospective case series with descriptive and analytical components. Patients presenting for the first time to the Eye Clinic of UCH, Ibadan, with histological diagnosis of orbit-ocular tumors were identified from the register at the Pathology Department, and their case records were retrieved. Information on age, sex, clinical history, type of tumor, clinical and histological diagnoses, adjuvant therapy, treatment status, recurrence and duration of follow-up was collected and analyzed with the use of SPSS 16. Analysis was considered to show significant association when the p value was less than 0.05. A total of 205 patients were analyzed giving a proportional morbidity of 0.4%. The median age of patients with orbito-ocular tumors was 7.0 years (range 4 months to 81 years) with a male. to female. ratio of 1.1: 1. About 56% of the patients were children. Retinoblastoma accounted for 46.8% and ocular surface squamous neoplasia 21% of the tumors. About 72% of the patients had lost vision from the tumor, while almost half of the patients presented with proptosis. More than half (51.4%) of the patients who did not complete their treatment schedule had had recurrence at one year of diagnosis, and patients with retinoblastomia who did not complete their treatment were about 52 times more likely to have recurrence (p=0.001). More than half (53%) of the patients did not keep their follow-up appointments. There was a strong correlation (87%) between clinical and histological diagnoses of patients with orbito-ocular tumors.. Orbito-ocula tumors still remain uncommon in our health institution. There appears to be a reduction in the number of cases seen compared to previous studies. Retinoblastoma was the commonest type of tumor in the orbito-ocular region, while melanomas are rare. There is urgent need for public enlightenment through the electronic media in both English and local languages on the signs of orbito-ocular tumors especially retinoblastoma, and encourage early presentation for treatment to increase the overall patient survival.