BackgroundRates of care abandonment for retinoblastoma (RB) demonstrate significant geographical variation; however, other variables that place a patient at risk of abandoning care remain unclear. This study aims to identify the risk factors for care abandonment across a multinational set of patients.MethodsA prospective, observational study of 692 patients from 11 RB centres in 10 countries was conducted from 1 January 2019 to 31 December 2019. Multivariate logistic regression was used to identify risk factors associated with higher rates of care abandonment.ResultsLogistic regression showed a higher risk of abandoning care based on country (high-risk countries include Bangladesh (OR=18.1), Pakistan (OR=45.5) and Peru (OR=9.23), p<0.001), female sex (OR=2.39, p=0.013) and advanced clinical stage (OR=4.22, p<0.001). Enucleation as primary treatment was not associated with a higher risk of care abandonment (OR=0.59, p=0.206).ConclusionCountry, advanced disease and female sex were all associated with higher rates of abandonment. In this analysis, enucleation as the primary treatment was not associated with abandonment. Further research investigating cultural barriers can enable the building of targeted retention strategies unique to each country.

Purpose: To describe a minimally invasive technique of harvesting fascia lata, and also to analyze the clinical uses and the outcome of fascia lata in Ophthalmic Plastic and Reconstructive surgery. Methods: This interventional study was done in three tertiary care eye hospitals in Bangladesh from July 2014 to June 2020. We obtained autologous fascia lata for the correction of congenital ptosis with poor levator function (⩽4 mm), covering the ciliary staphyloma, repair of the extruded implant following anophthalmic socket surgery, and was also used to wrap the orbital implant after enucleation. Preserved FL was used only for children before 6 years of age for the treatment of congenital ptosis. Results: Out of 60 subjects, 38 (63.3%) were male and 22 (36.7%) were female. Autogenous fascia lata was used for frontalis brow suspension (FBS) in 25 (41.67%) patients of congenital ptosis with poor levator function, as patch graft in ciliary staphyloma (11 cases, 18.3%), to wrap orbital implant following enucleation in intraocular malignancies (nine cases, 15%), to repair of implant extrusion following evisceration (five cases, 8.3%), and as fascial sling to correct recurrent paralytic ectropion (one case, 1.67%). Allogeneic or preserved fascia lata was used to correct congenital ptosis in patients less than 6 years of age (nine cases, 15%). Mean follow-up time was 5.32 months. Conclusion: Fascia lata (autogenous and allogeneic preserved) has varied uses in ophthalmic plastic surgery. Harvesting fascia lata (FL) using with minimally invasive method was successful with the least scar on the thigh to correct congenital ptosis, ciliary staphyloma, repair of extruded implant, and in wrapping implant after enucleation to get better cosmesis and motility.

Purpose: To evaluate the presentation and outcome of periocular capillary hemangioma treated with low-dose oral propranolol. Method: Thirty cases of periocular capillary hemangioma prospectively studied from 1st June 2015 to 31st May 2017 who received oral propranolol on an outpatient basis. Hemangioma causing any threat to vision or disfigurement was included and age below 3 months and multiple lesions were excluded. Starting dose of propranolol was 1 mg/kg and increased to 2 mg/kg after 2 weeks as a maintenance dose. The tapering dose was 1 mg/kg of body weight before discontinuing the medication. Treatment was continued till the child is 1 year of age or no further change in color or size of the lesion in two successive follow-ups. Results: Presenting age was 6.36 ± 3.36 months (ranged 3–24 months) with female predominance (70%). In 86.6% of cases, the vision was Central Steady and Maintained and cycloplegic refraction showed marked astigmatism in 3 children which resolved after treatment. Forty-six percent of children showed color change as an initial response to treatment. Most children (33.3%) responded completely within 5 months after starting the treatment. One third patients (33.3%) showed 100% resolution, 50% showed 90% to 70% resolution. Pretreatment and post-treatment lesion size was1.60 ± 0.86 cm2 and 0.30 ± 0.40 cm2 respectively (p - value < 0.0005). None showed any significant adverse effect of oral propranolol. Conclusion: Low-dose oral propranolol is an effective and cost-effective treatment modality for periocular capillary hemangioma and is safe as an outpatient basis.

3MC syndrome is a very rare entity. It’s prevalence is unknown but most cases are reported from Middle East. First case was reported in 1978 and named as Michel syndrome and recently with other three syndromes together these syndromes are named as 3 MC syndrome. All are autosomal recessive disorder and reported from both consanguineous and non- consanguineous parents. Here we phenotypically analyzed a case presented with the features of blepharophimosis syndrome associated with craniosynostosis suggestive of Mischel syndrome which is a part of ‘3 MC syndrome’.

Retinoblastoma is the most common primary intraocular tumor in children with an incidence of 1:16,000 to 18,000 live birth. Worldwide newly detected cases per year are about 8000 and in India above 1400. It represents 11% of cancer that develops in the first year of life. The revolutionary management strategy has increased the survival rate of retinoblastoma above 95% in developed countries, and this rate is the highest among all pediatric cancers. But still, it is deadly cancer worldwide. Survival from retinoblastoma based on income >90% vs. 40% (in high to low-income countries). The incidence of metastasis is more in lower-income countries (32% vs. 12% in middle-income). Notably, Forty-three percent of the world’s estimated cases reside in only 6 countries in Asia (China, Indonesia, Philippines, India, Pakistan, and Bangladesh). The mortality rate varies on different continents. Worldwide estimated death from retinoblastoma is more than 40%, and most of them are from Asia and Africa. Bangladesh is one of the developing countries in the South-East Asia region, and retinoblastoma constitutes 83% of all pediatric cancer under 4 years of age. For proper management of retinoblastoma with an international standard, the establishment of a retinoblastoma center consisting of ocular oncologist, clinical oncologist, radiation oncologist, pediatrician, oculoplastic surgeon, retina specialist, pediatric ophthalmologist, and ocularist is needed. Management includes proper diagnosis, treatment of the disease, genetic counseling, regular follow-up, rehabilitation of survivors, and screening of siblings. Chittagong Eye Infirmary & Training Complex is a tertiary eye care center and one of the referral centers of Bangladesh and is treating retinoblastoma since its inception. Due to the demand of time, the hospital has been reorganized with various facilities to serve retinoblastoma patients with a team approach in 2017. From January 2017 to March 2022, a total of 304 patients were diagnosed. Among them, 132 received vincristine, etoposide, and carboplatin (VEC) chemotherapy from this center, and 79 underwent enucleation with the long optic nerve. Besides treatment, the hospital is conducting sibling screening, visual and psycho-social rehabilitation for the RB survivors, and community awareness programs.