Intravitreal chemotherapy (IVitC) in the management of retinoblastoma has increased the rate of globe salvage, specifically in patients with recurrent disease and associated vitreous seeds. A significant number of children with retinoblastoma in developing countries present late, resulting in higher intraocular tumour-stage at presentation. Treatment requirements for such tumours usually include intravenous chemotherapy (IVC) and/or intra-arterial chemotherapy (IAC). While IVC has a long usage track record and a good efficacy, it has been reported to be associated with higher recurrence rates in a significant number of patients. Intra-arterial chemotherapy has the advantage of lower recurrence rates but requires personnel with advanced interventional radiology skills and has limited efficacy in treating intravitreal seeds. Intravitreal chemotherapy has gained popularity recently, largely because of its superior efficacy in the management of vitreous seeds, subretinal seeds and recurrent retinal tumour. An 8-month-old male infant initially presented with bilateral retinoblastoma, International Classification System for Intraocular Retinoblastoma (ICRB) Group E in the right eye and Group B on the left eye. The right eye was enucleated and currently has a prosthesis. The left eye had tumours that initially responded to brachytherapy and transpupillary thermotherapy (TTT). Approximately two years later his tumours recurred with vitreous seeds and were successfully managed with the use of cryotherapy and intravitreal chemotherapy. The simplicity of the technique of IVitC and its efficacy in controlling vitreous seeds and recurrent retinal tumours makes this route of regional chemotherapy a viable one in areas with limited expertise and resources such as South Africa.

Background: Timeous screening of retinopathy of prematurity (ROP) is an important predictor of ROP screening outcomes, and hospitals at different levels of care might have different access to ROP screening by ophthalmologists, resulting in different ROP screening outcomes.Objective: To compare ROP screening outcomes between premature babies from a neonatal facility at a central hospital to those from regional hospitals in Johannesburg.Setting: Retinopathy of prematurity screening in babies born at central and non-central hospitals in Johannesburg, South Africa, between 01 January 2015 and 31 June 2020.Methods: A cross-sectional study describing clinical findings in babies referred for ROP screening at a central Johannesburg hospital.Results: A total of 2035 ROP screening records were included in the study. The babies screened from the central hospital and regional hospitals were 1081 (53.1%) and 954 (46.9%), respectively. The proportion of babies with ROP were 125 (11.6%) and 121 (12.7%) in the central hospital and regional hospitals, respectively, and this difference was not statistically significant, p = 0.435. There was a significant association between gestational age (GA) categories and birth weight (BW) with the hospital of birth, with proportionately more babies with GA 28 weeks, 212 (19.6%) versus 158 (16.6%) p  0.001, and BW 1500 g, 894 (82.7%) versus 737 (77.3%) p = 0.001, being referred by the central hospital compared to regional hospitals.Conclusion: The prevalence of ROP in regional hospitals does not seem to differ from that found in central hospitals.