RETINOBLASTOMA: CLINICAL MANIFESTATIONS AND SURGICAL TREATMENT

Abstract

Introduction: Retinoblastoma is a malignant tumor that originates from retinal cells, the layer responsible for capturing light and forming images in the eye. Early diagnosis is essential to increase the chances of cure and preservation of vision. The main symptom is leukocoria, a white reflection in the pupil, which may be noticed by the child's parents or relatives, especially under artificial light or in flash photos. Eye removal surgery (enucleation) is indicated in cases of unilateral tumor at an advanced stage, when other options are not effective or possible. Objective: to evaluate the clinical manifestations and surgical treatment of retinoblastoma. Methodology: A search was carried out in the PubMed, Scielo and Web of Science databases, using the following descriptors: retinoblastoma, clinical manifestations, surgical treatment, outcomes and complications. Only articles published in the last 10 years, in Portuguese or English, that addressed the proposed topic were included. Articles that were not original and that did not present sufficient data were excluded. Followed the PRISMA checklist. Results: 16 studies were selected. Leukocoria was the most frequent and earliest symptom of retinoblastoma, present in 80% to 90% of cases. Strabismus was the second most common symptom, observed in 20% to 30% of cases. Enucleation was the most commonly performed surgical treatment, in 60% to 80% of unilateral cases and in 10% to 20% of bilateral cases. Eye preservation was associated with a lower survival rate (80% to 90%), but also with a greater chance of maintaining vision and better emotional well-being. The main complications of surgical treatment were: infection, hemorrhage, retinal detachment, cataract, glaucoma, necrosis, atrophy and tumor recurrence. Conclusion: Retinoblastoma is a serious eye cancer that requires early diagnosis and treatment to increase the chances of cure and preservation of vision. Surgical treatment is one of the therapeutic options, which can be performed alone or combined with other modalities. Enucleation is the most common and most effective procedure, but also the most invasive and traumatic.