Aim To describe the clinical presentation and group classification of newly diagnosed retinoblastoma patients in China, and to identify future priorities for improving the medical care of this disease. Methods The retrospective review included all patients who presented with previously untreated intraocular retinoblastoma at Beijing Tongren Hospital between August 2006 and August 2009. The clinical charts were reviewed and fundus images taken for all patients were analysed. The tumours were classified according to the International Intraocular Retinoblastoma Classification. Results The study included 595 eyes (470 patients) with untreated retinoblastoma. The mean age at diagnosis was 23 months, with 84% of the patients being younger than 3 years at the time of diagnosis. Bilateral retinoblastoma was present in 150 (32%) of the patients. Bilateral retinoblastoma as compared with unilateral retinoblastoma was diagnosed at a significantly (p<0.001) younger mean age (15 months vs 27 months). Leucocoria was the most common leading sign (73% of patients). The vast majority of eyes (501/595 or 84%) presented with an advanced stage of the tumour (Group D or E of International Intraocular Retinoblastoma Classification). Conclusion In China, diagnosis of retinoblastoma occurs at a relatively advanced clinical stage of the disease. An intensified programme for earlier detection of retinoblastoma including educating parents and physicians may be warranted to improve clinical outcome with fewer enucleations.

BackgroundUniversal ocular screening of infants is not a standard procedure in children’s health care system in China. This pilot study investigated prevalence of ocular abnormalities of 6 weeks-age infants using wide-field digital imaging system.MethodsInfants aged 6 weeks around were consecutively enrolled in a public hospital between April 2015 and August 2016. All the infants who were enrolled in the study underwent vision assessment, eye position examination, external eye check, pupillary light reflex, red reflex examination, anterior and posterior ocular segments were examined using flashlight, ophthalmoscope, and wide-field digital imaging system.ResultsA total of 481 infants at 45.1 ± 6.1 days after birth were enrolled in the study. 198 infants had abnormal findings (41.2%). Retinal white spots and retinal white areas were the most common findings (42.9% of abnormalities and 17.7% of all infants screened). The second major finding was retinal hemorrhage (16.2% of abnormalities and 6.7% of all infants screened). Other abnormal findings include retinal pigmentation, concomitant exotropia, neonatal dacryocystitis, retinopathy of prematurity, ‘albinism-like fundus’, congenital nasolacrimal duct obstruction, familial exudative vitreoretinopathy, immature retina, corneal dermoid tumor, large physiologic cupping of optic disc, congenital persistent pupillary membrane, entropion trichiasis, subconjunctival hemorrhage, congenital cataract, vitreous hemorrhage, ptosis and choroidal nevus. Intervention of any form was required in 22 infants, which accounted for 11.1% of abnormalities detected and 4.6% of all infants screened.ConclusionUniversal ocular screening is not only necessary for preterm infants but also for full-term infants. Addition of red reflex examination with wide-field digital imaging system can enhance the sensitivity of screening for ocular fundus abnormities. Further study with a long-term follow-up is needed in the future.

Frequency-domain OCT (RTVue OCT) may offer comprehensive analysis for RNFL thickness and ONH, which showed good diagnostic ability in distinguishing normal from glaucomatous eyes.