. 2020 May 1;6(5):685-695.

doi: 10.1001/jamaoncol.2019.6716.

Global Retinoblastoma Presentation and Analysis by National Income Level

Global Retinoblastoma Study Group; Ido Didi Fabian^{1

2}, Elhassan Abdallah³, Shehu U Abdullahi⁴, Rula A Abdulqader⁵, Sahadatou Adamou Boubacar⁶, Dupe S Ademola-Popoola⁷, Adedayo Adio⁸, Armin R Afshar⁹, Priyanka Aggarwal¹⁰, Ada E Aghaji¹¹, Alia Ahmad¹², Marliyanti N R Akib¹³, Lamis Al Harby¹⁴, Mouroge H Al Ani¹⁵, Aygun Alakbarova¹⁶, Silvia Alarcón Portabella¹⁷, Safaa A F Al-Badri¹⁸, Ana Patricia A Alcasabas¹⁹, Saad A Al-Dahmash²⁰, Amanda Alejos²¹, Ernesto Alemany-Rubio²², Amadou I Alfa Bio²³, Yvania Alfonso Carreras²⁴, Christiane Al-Haddad²⁵, Hamoud H Y Al-Hussaini²⁶, Amany M Ali²⁷, Donjeta B Alia²⁸, Mazin F Al-Jadiry¹⁸, Usama Al-Jumaily²⁹, Hind M Alkatan²⁰, Charlotta All-Eriksson³⁰, Ali A R M Al-Mafrachi³¹, Argentino A Almeida³², Khalifa M Alsawidi³³, Athar A S M Al-Shaheen⁵, Entissar H Al-Shammary³⁴, Primawita O Amiruddin³⁵, Romanzo Antonino³⁶, Nicholas J Astbury¹, Hatice T Atalay³⁷, La-Ongsri Atchaneeyasakul³⁸, Rose Atsiaya³⁹, Taweevat Attaseth⁴⁰, Than H Aung⁴¹, Silvia Ayala⁴², Baglan Baizakova⁴³, Julia Balaguer⁴⁴, Ruhengiz Balayeva¹⁶, Walentyna Balwierz⁴⁵, Honorio Barranco⁴⁴, Covadonga Bascaran¹, Maja Beck Popovic⁴⁶, Raquel Benavides⁴⁷, Sarra Benmiloud⁴⁸, Nissrine Bennani Guebessi⁴⁹, Rokia C Berete⁵⁰, Jesse L Berry⁵¹, Anirban Bhaduri⁵², Sunil Bhat⁵³, Shelley J Biddulph⁵⁴, Eva M Biewald⁵⁵, Nadia Bobrova⁵⁶, Marianna Boehme⁵⁵, H C Boldt⁵⁷, Maria Teresa B C Bonanomi⁵⁸, Norbert Bornfeld⁵⁵, Gabrielle C Bouda⁵⁹, Hédi Bouguila⁶⁰, Amaria Boumedane⁶¹, Rachel C Brennan⁶², Bénédicte G Brichard⁶³, Jassada Buaboonnam³⁸, Patricia Calderón-Sotelo⁶⁴, Doris A Calle Jara⁶⁵, Jayne E Camuglia⁶⁶, Miriam R Cano⁶⁷, Michael Capra⁶⁸, Nathalie Cassoux⁶⁹, Guilherme Castela⁷⁰, Luis Castillo⁷¹, Jaume Català-Mora⁷², Guillermo L Chantada^{72

73

74}, Shabana Chaudhry⁷⁵, Sonal S Chaugule⁷⁶, Argudit Chauhan⁷⁷, Bhavna Chawla⁷⁸, Violeta S Chernodrinska⁷⁹, Faraja S Chiwanga⁸⁰, Tsengelmaa Chuluunbat⁸¹, Krzysztof Cieslik⁸², Ruellyn L Cockcroft⁸³, Codruta Comsa⁸⁴, Zelia M Correa⁸⁵, Maria G Correa Llano⁷², Timothy W Corson⁸⁶, Kristin E Cowan-Lyn⁸⁷, Monika Csóka⁸⁸, Xuehao Cui⁸⁹, Isac V Da Gama⁹⁰, Wantanee Dangboon⁹¹, Anirban Das⁹², Sima Das⁹³, Jacquelyn M Davanzo⁹⁴, Alan Davidson⁹⁵, Patrick De Potter⁶³, Karina Q Delgado⁹⁶, Hakan Demirci⁹⁷, Laurence Desjardins⁹⁸, Rosdali Y Diaz Coronado⁹⁹, Helen Dimaras¹⁰⁰, Andrew J Dodgshun¹⁰¹, Craig Donaldson¹⁰², Carla R Donato Macedo¹⁰³, Monica D Dragomir⁸⁴, Yi Du¹⁰⁴, Magritha Du Bruyn¹⁰⁵, Kemala S Edison¹⁰⁶, I Wayan Eka Sutyawan¹⁰⁷, Asmaa El Kettani⁴⁹, Amal M Elbahi³³, James E Elder^{108

109}, Dina Elgalaly¹¹⁰, Alaa M Elhaddad¹¹⁰, Moawia M Ali Elhassan¹¹¹, Mahmoud M Elzembely²⁷, Vera A Essuman¹¹², Ted Grimbert A Evina¹¹³, Zehra Fadoo¹¹⁴, Adriana C Fandiño⁷³, Mohammad Faranoush¹¹⁵, Oluyemi Fasina¹¹⁶, Delia D P G Fernández¹¹⁷, Ana Fernández-Teijeiro¹¹⁸, Allen Foster¹, Shahar Frenkel¹¹⁹, Ligia D Fu¹²⁰, Soad L Fuentes-Alabi¹²¹, Brenda L Gallie¹⁰⁰, Moira Gandiwa¹²², Juan L Garcia¹²³, David García Aldana¹²⁴, Pascale Y Gassant²⁴, Jennifer A Geel¹²⁵, Fariba Ghassemi¹²⁶, Ana V Girón²¹, Zelalem Gizachew¹²⁷, Marco A Goenz¹²¹, Aaron S Gold¹²⁸, Maya Goldberg-Lavid¹²⁹, Glen A Gole⁶⁶, Nir Gomel¹³⁰, Efren Gonzalez¹³¹, Graciela Gonzalez Perez¹³², Liudmira González-Rodríguez²², Henry N Garcia Pacheco¹³³, Jaime Graells¹³⁴, Liz Green¹³⁵, Pernille A Gregersen¹³⁶, Nathalia D A K Grigorovski¹³⁷, Koffi M Guedenon¹³⁸, D Sanjeeva Gunasekera¹³⁹, Ahmet K Gündüz¹⁴⁰, Himika Gupta¹⁴¹, Sanjiv Gupta¹⁴², Theodora Hadjistilianou¹⁴³, Patrick Hamel¹⁴⁴, Syed A Hamid¹⁴⁵, Norhafizah Hamzah¹⁴⁶, Eric D Hansen¹⁴⁷, J William Harbour¹⁴⁸, M Elizabeth Hartnett¹⁴⁷, Murat Hasanreisoglu³⁷, Sadiq Hassan⁴, Shadab Hassan¹⁴⁹, Stanislava Hederova¹⁵⁰, Jose Hernandez¹⁵¹, Lorelay Marie Carcamo Hernandez⁹⁶, Laila Hessissen¹⁵², Diriba F Hordofa¹⁵³, Laura C Huang¹⁵⁴, G B Hubbard¹⁵⁵, Marlies Hummlen¹⁵⁶, Kristina Husakova¹⁵⁰, Allawi N Hussein Al-Janabi³⁴, Russo Ida³⁶, Vesna R Ilic¹⁵⁷, Vivekaraj Jairaj¹⁵⁸, Irfan Jeeva¹¹⁴, Helen Jenkinson¹⁵⁹, Xunda Ji⁸⁹, Dong Hyun Jo¹⁶⁰, Kenneth P Johnson¹⁶¹, William J Johnson¹⁶², Michael M Jones¹⁰², Theophile B Amani Kabesha¹⁶³, Rolande L Kabore⁵⁹, Swathi Kaliki¹⁶⁴, Abubakar Kalinaki¹⁶⁵, Mehmet Kantar¹⁶⁶, Ling-Yuh Kao¹⁶⁷, Tamar Kardava¹⁶⁸, Rejin Kebudi¹⁶⁹, Tomas Kepak¹⁷⁰, Naama Keren-Froim¹²⁹, Zohora J Khan¹⁷¹, Hussain A Khaqan¹⁷², Phara Khauv¹⁷³, Wajiha J Kheir¹⁷⁴, Vikas Khetan¹⁷⁵, Alireza Khodabande¹²⁶, Zaza Khotenashvili¹⁶⁸, Jonathan W Kim⁵¹, Jeong Hun Kim¹⁷⁶, Hayyam Kiratli¹⁷⁷, Tero T Kivelä¹⁷⁸, Artur Klett¹⁷⁹, Jess Elio Kosh Komba Palet¹⁸⁰, Dalia Krivaitiene¹⁸¹, Mariana Kruger¹⁸², Kittisak Kulvichit¹⁸³, Mayasari W Kuntorini³⁵, Alice Kyara⁸⁰, Eva S Lachmann¹⁸⁴, Carol P S Lam¹⁸⁵, Geoffrey C Lam¹⁸⁶, Scott A Larson⁵⁷, Slobodanka Latinovic¹⁸⁷, Kelly D Laurenti¹⁸⁸, Bao Han A Le¹⁸⁹, Karin Lecuona¹⁹⁰, Amy A Leverant¹⁹¹, Cairui Li¹⁹², Ben Limbu¹⁹³, Quah Boon Long¹⁹⁴, Juan P López¹⁹⁵, Robert M Lukamba¹⁹⁶, Livia Lumbroso⁹⁸, Sandra Luna-Fineman¹⁹⁷, Delfitri Lutfi¹⁹⁸, Lesia Lysytsia¹⁹⁹, George N Magrath¹⁶², Amita Mahajan²⁰⁰, Abdul Rahim Majeed¹³⁵, Erika Maka⁸⁸, Mayuri Makan²⁰¹, Emil K Makimbetov²⁰², Chatonda Manda¹²², Nieves Martín Begue¹⁷, Lauren Mason²⁰³, John O Mason 3rd²⁰³, Ibrahim O Matende³⁹, Miguel Materin¹⁷⁴, Clarissa C D S Mattosinho¹³⁷, Marchelo Matua²⁰⁴, Ismail Mayet⁵⁴, Freddy B Mbumba²⁰⁵, John D McKenzie^{108

206}, Aurora Medina-Sanson²⁰⁷, Azim Mehrvar²⁰⁸, Aemero A Mengesha²⁰⁹, Vikas Menon²¹⁰, Gary John V D Mercado¹⁹, Marilyn B Mets¹⁸⁸, Edoardo Midena²¹¹, Divyansh K C Mishra²¹², Furahini G Mndeme²¹³, Ahmed A Mohamedani²¹⁴, Mona T Mohammad²¹⁵, Annette C Moll²¹⁶, Margarita M Montero²¹⁷, Rosa A Morales⁶⁴, Claude Moreira²¹⁸, Prithvi Mruthyunjaya¹⁵⁴, Mchikirwa S Msina²¹³, Gerald Msukwa¹²², Sangeeta S Mudaliar¹⁴¹, Kangwa I Muma²¹⁹, Francis L Munier²²⁰, Gabriela Murgoi⁸⁴, Timothy G Murray¹²⁸, Kareem O Musa²²¹, Asma Mushtaq¹², Hamzah Mustak¹⁹⁰, Okwen M Muyen²²², Gita Naidu⁵⁴, Akshay Gopinathan Nair^{223

224}, Larisa Naumenko²²⁵, Paule Aïda Ndoye Roth²²⁶, Yetty M Nency²²⁷, Vladimir Neroev²²⁸, Hang Ngo²²⁹, Rosa M Nieves²¹⁷, Marina Nikitovic¹⁵⁷, Elizabeth D Nkanga²³⁰, Henry Nkumbe¹¹³, Murtuza Nuruddin²³¹, Mutale Nyaywa²³², Ghislaine Obono-Obiang²³³, Ngozi C Oguego¹¹, Andrzej Olechowski⁸², Scott C N Oliver²³⁴, Peter Osei-Bonsu²³⁵, Diego Ossandon²³⁶, Manuel A Paez-Escamilla¹⁴⁸, Halimah Pagarra¹³, Sally L Painter¹⁵⁹, Vivian Paintsil²³⁵, Luisa Paiva²³⁷, Bikramjit P Pal²³⁸, Mahesh Shanmugam Palanivelu²¹², Ruzanna Papyan²³⁹, Raffaele Parrozzani²¹¹, Manoj Parulekar¹⁵⁹, Claudia R Pascual Morales¹⁵¹, Katherine E Paton²⁴⁰, Katarzyna Pawinska-Wasikowska⁴⁵, Jacob Pe'er¹¹⁹, Armando Peña¹²⁰, Sanja Peric²⁴¹, Chau T M Pham²⁴², Remezo Philbert²⁴³, David A Plager⁸⁶, Pavel Pochop²⁴⁴, Rodrigo A Polania²⁴⁵, Vladimir G Polyakov^{246

247}, Manca T Pompe²⁴⁸, Jonathan J Pons²⁴⁹, Daphna Prat², Vireak Prom¹⁷⁵, Ignatius Purwanto²⁵⁰, Ali O Qadir²⁵¹, Seema Qayyum¹², Jiang Qian²⁵², Ardizal Rahman¹⁰⁶, Salman Rahman⁹, Jamalia Rahmat¹⁴⁶, Purnima Rajkarnikar¹⁹³, Rajesh Ramanjulu²¹², Aparna Ramasubramanian⁷⁷, Marco A Ramirez-Ortiz²⁵³, Léa Raobela²⁵⁴, Riffat Rashid²⁵⁵, M Ashwin Reddy¹⁴, Ehud Reich²⁵⁶, Lorna A Renner²⁵⁷, David Reynders²⁵⁸, Dahiru Ribadu²⁵⁹, Mussagy M Riheia²⁶⁰, Petra Ritter-Sovinz²⁶¹, Duangnate Rojanaporn⁴⁰, Livia Romero¹³⁴, Soma R Roy²³¹, Raya H Saab²⁶², Svetlana Saakyan²²⁸, Ahmed H Sabhan¹⁸, Mandeep S Sagoo²⁶³, Azza M A Said²⁶⁴, Rohit Saiju¹⁹³, Beatriz Salas²⁶⁵, Sonsoles San Román Pacheco²⁶⁶, Gissela L Sánchez²⁶⁷, Phayvanh Sayalith²⁶⁸, Trish A Scanlan⁸⁰, Amy C Schefler⁴², Judy Schoeman²⁵⁸, Ahad Sedaghat²⁶⁹, Stefan Seregard³⁰, Rachna Seth²⁷⁰, Ankoor S Shah¹³¹, Shawkat A Shakoor²⁷¹, Manoj K Sharma²⁷², Sadik T Sherief¹²⁷, Nandan G Shetye²⁷³, Carol L Shields²⁷⁴, Sorath Noorani Siddiqui¹⁴⁹, Sidi Sidi Cheikh²⁷⁵, Sónia Silva⁷⁰, Arun D Singh⁹⁴, Niharika Singh¹⁷⁵, Usha Singh²⁷⁶, Penny Singha⁹¹, Rita S Sitorus²⁷⁷, Alison H Skalet²⁷⁸, Hendrian D Soebagjo¹⁹⁸, Tetyana Sorochynska⁵⁶, Grace Ssali²⁷⁹, Andrew W Stacey²⁸⁰, Sandra E Staffieri^{108

281}, Erin D Stahl²⁸², Christina Stathopoulos²²⁰, Branka Stirn Kranjc²⁴⁸, David K Stones²⁸³, Caron Strahlendorf²⁸⁴, Maria Estela Coleoni Suarez²⁸⁵, Sadia Sultana²⁵⁵, Xiantao Sun²⁸⁶, Meryl Sundy²⁷⁸, Rosanne Superstein¹⁴⁴, Eddy Supriyadi²⁵⁰, Supawan Surukrattanaskul²⁸⁷, Shigenobu Suzuki²⁸⁸, Karel Svojgr²⁸⁹, Fatoumata Sylla²⁹⁰, Gevorg Tamamyan²³⁹, Deborah Tan¹⁹⁴, Alketa Tandili²⁸, Fanny F Tarrillo Leiva²⁹¹, Maryam Tashvighi²⁰⁸, Bekim Tateshi²⁹², Edi S Tehuteru²⁹³, Luiz F Teixeira^{103

294}, Kok Hoi Teh¹⁴⁶, Tuyisabe Theophile²⁹⁵, Helen Toledano²⁹⁶, Doan L Trang²⁴², Fousseyni Traoré²⁹⁷, Sumalin Trichaiyaporn²⁸⁷, Samuray Tuncer²⁹⁸, Harba Tyau-Tyau²⁹⁹, Ali B Umar⁴, Emel Unal³⁰⁰, Ogul E Uner¹⁵⁵, Steen F Urbak³⁰¹, Tatiana L Ushakova^{246

247}, Rustam H Usmanov³⁰², Sandra Valeina³⁰³, Milo van Hoefen Wijsard²¹⁶, Adisai Varadisai¹⁸³, Liliana Vasquez²⁹¹, Leon O Vaughan⁸⁷, Nevyana V Veleva-Krasteva⁷⁹, Nishant Verma¹⁴², Andi A Victor²⁷⁷, Maris Viksnins³⁰³, Edwin G Villacís Chafla⁶⁵, Vicktoria Vishnevskia-Dai², Tushar Vora²⁷³, Antonio E Wachtel⁹⁹, Werner Wackernagel³⁰⁴, Keith Waddell²⁰⁴, Patricia D Wade³⁰⁵, Amina H Wali³⁰⁶, Yi-Zhuo Wang³⁰⁷, Avery Weiss²⁸⁰, Matthew W Wilson³⁰⁸, Amelia D C Wime²³⁷, Atchareeya Wiwatwongwana³⁰⁹, Damrong Wiwatwongwana³⁰⁹, Charlotte Wolley Dod¹⁷, Phanthipha Wongwai³¹⁰, Daoman Xiang³¹¹, Yishuang Xiao³¹², Jason C Yam¹⁸⁵, Huasheng Yang³¹³, Jenny M Yanga³¹⁴, Muhammad A Yaqub³¹⁵, Vera A Yarovaya³¹⁶, Andrey A Yarovoy³¹⁶, Huijing Ye³¹³, Yacoub A Yousef²¹⁵, Putu Yuliawati¹⁰⁷, Arturo M Zapata López⁹⁹, Ekhtelbenina Zein³¹⁷, Chengyue Zhang³¹⁸, Yi Zhang³⁰⁷, Junyang Zhao³¹⁸, Xiaoyu Zheng³¹⁹, Katsiaryna Zhilyaeva²²⁵, Nida Zia¹⁴⁵, Othman A O Ziko²⁶⁴, Marcia Zondervan¹, Richard Bowman^{1

320}

Affiliations

¹ International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
² The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel.
³ Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco.
⁴ Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria.
⁵ Basra Children's Specialty Hospital, Basra, Iraq.
⁶ National Hospital of Niamey, Niamey, Niger.
⁷ University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria.
⁸ Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
⁹ University of California, San Francisco.
¹⁰ Department of Pediatrics, Banaras Hindu University, Varanasi, India.
¹¹ Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria.
¹² The Children's Hospital and the Institute of Child Health, Lahore, Pakistan.
¹³ RS Dr Wahidin Sudirohusodo, Makassar, Indonesia.
¹⁴ The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
¹⁵ Hawler Medical University, Erbil, Iraq.
¹⁶ Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan.
¹⁷ Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain.
¹⁸ Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq.
¹⁹ Philippine General Hospital, University of the Philippines, Manila, Philippines.
²⁰ College of Medicine, King Saud University, Riyadh, Saudi Arabia.
²¹ Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala.
²² Instituto Cubano de Oftalmología Ramón Pando Ferrer, Marianao, Havana, Cuba.
²³ University of Parakou, Parakou, Benin.
²⁴ St Damien Pediatric Hospital, Port-au-Prince, Haiti.
²⁵ Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
²⁶ Pediatric Oncology Department, National Oncology Center, Sana'a, Yemen.
²⁷ Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
²⁸ University Hospital Center Mother Theresa, Tirana, Albania.
²⁹ Imam Hussein Cancer Center, Karbala, Iraq.
³⁰ St Erik Eye Hospital, Stockholn, Sweden.
³¹ Ibn Al Haitham Teaching Eye Hospital, Baghdad, Iraq.
³² Beira Central Hospital, Beira, Mozambique.
³³ Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya.
³⁴ Oncology Unit, Child's Central Teaching Hospital, Baghdad, Iraq.
³⁵ National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia.
³⁶ Bambino Gesù IRCCS Children's Hospital, Rome, Italy.
³⁷ Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey.
³⁸ Siriraj Hospital, Mahidol University, Bangkok, Thailand.
³⁹ Lighthouse For Christ Eye Centre, Mombasa, Kenya.
⁴⁰ Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
⁴¹ Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar.
⁴² Retina Consultants of Houston, Houston, Texas.
⁴³ Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan.
⁴⁴ Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
⁴⁵ Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland.
⁴⁶ Pediatric Hematology-Oncology Unit, Lausanne University Hospital, Lausanne, Switzerland.
⁴⁷ Hospital Nacional de Niños Dr Carlos Sáenz Herrera, San Jose, Costa Rica.
⁴⁸ Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco.
⁴⁹ Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco.
⁵⁰ Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire.
⁵¹ Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles.
⁵² The Calcutta Medical Research Institute, Kolkata, India.
⁵³ Department of Pediatric Hematology and Oncology, Narayana Health City, Bangalore, India.
⁵⁴ University of the Witwatersrand, Johannesburg, South Africa.
⁵⁵ Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany.
⁵⁶ The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine.
⁵⁷ Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City.
⁵⁸ Hospital das Clínicas da FMUSP, São Paulo, Brazil.
⁵⁹ Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso.
⁶⁰ Institut Hédi Raïs d'Ophtalmologie, Faculté de Médecine, Université Tunis El Manar, Tunis, Tunisia.
⁶¹ Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria.
⁶² Solid Tumor Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
⁶³ Cliniques Universitaires Saint-Luc, Brussel, Belgium.
⁶⁴ Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua.
⁶⁵ Hospital del Niño Dr. Francisco De Icaza Bustamante, Guayaquil, Ecuador.
⁶⁶ Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia.
⁶⁷ Salud Ocular, Ministerio de Salud Publica, Asuncion, Paraguay.
⁶⁸ Our Lady's Children's Hospital, Dublin, Ireland.
⁶⁹ Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France.
⁷⁰ Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal.
⁷¹ Hospital Pereira Rossell, Montevideo, Uruguay.
⁷² Hospital Sant Joan de Déu, Barcelona, Spain.
⁷³ Hospital Garrahan, Buenos Aires, Argentina.
⁷⁴ NationalScientific and Technical Research Council, CONICET, Buenos Aires, Argentina.
⁷⁵ Paediatric Ophthalmology Department, Mayo Hospital and College of Allied Visual Sciences, King Edward Medical University, Lahore, Pakistan.
⁷⁶ Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India.
⁷⁷ University of Louisville, Louisville, Kentucky.
⁷⁸ Ocular Oncology Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
⁷⁹ Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria.
⁸⁰ Muhimbili National Hospital, Dar es Salaam, Tanzania.
⁸¹ National Center for Maternal and Children Health of Mongolia, Ulaanbaatar, Mongolia.
⁸² Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland.
⁸³ Starship Children's Health, Auckland, New Zealand.
⁸⁴ Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania.
⁸⁵ Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, and University of Cincinnati College of Medicine, Cincinnati, Ohio.
⁸⁶ Indiana University Medical Center, Indianapolis.
⁸⁷ Bustamante Hospital for Children, Kingston, Jamaica.
⁸⁸ Semmelweis University, Budapest, Hungary.
⁸⁹ Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁹⁰ Quelimane Central Hospital, Quelimane, Mozambique.
⁹¹ Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand.
⁹² Department of Pediatric Hematology-Oncology, Tata Medical Center, Kolkata, India.
⁹³ Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India.
⁹⁴ Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
⁹⁵ Red Cross War Memorial Children's Hospital and the University of Cape Town, Cape Town, South Africa.
⁹⁶ National Children's Hospital, Panama City, Panama.
⁹⁷ Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor.
⁹⁸ Institut Curie, Paris, France.
⁹⁹ Instituto Nacional de Enfermedades Neoplasicas, Lima, Perú.
¹⁰⁰ The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁰¹ Department of Paediatrics, University of Otago, Christchurch, Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand.
¹⁰² The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
¹⁰³ Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil.
¹⁰⁴ Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
¹⁰⁵ University of KwaZulu-Natal, Durban, South Africa.
¹⁰⁶ Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia.
¹⁰⁷ Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia.
¹⁰⁸ Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia.
¹⁰⁹ Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia.
¹¹⁰ Children's Cancer Hospital Egypt 57357, Cairo, Egypt.
¹¹¹ Department of Oncology, National Cancer Institute, University of Gezira, Wadi Madani, Sudan.
¹¹² Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
¹¹³ Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon.
¹¹⁴ Aga Khan University, Karachi, Pakistan.
¹¹⁵ Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran.
¹¹⁶ Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Nigeria.
¹¹⁷ Mi Clinic, Ciudad del Este, Paraguay.
¹¹⁸ Hospital Universitario Virgen Macarena, Sevilla, Spain.
¹¹⁹ Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
¹²⁰ Hospital Escuela, Tegucigalpa, Honduras.
¹²¹ Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador.
¹²² Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi.
¹²³ ClínicaAnglo American, Lima, Perú.
¹²⁴ Servicio Andaluz de Salud, Sevilla, Spain.
¹²⁵ Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
¹²⁶ Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
¹²⁷ Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
¹²⁸ Murray Ocular Oncology and Retina, Miami, Florida.
¹²⁹ Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹³⁰ Department of Ophthalmology, Sourasky Medical Center Tel Aviv, School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹³¹ Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
¹³² Hospital Civil de Guadalajara, Guadalajara, Mexico.
¹³³ Pediatric Oncology Unit, Instituto Regional de Enfermedades Neoplásicas del Sur, Arequipa, Perú.
¹³⁴ Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela.
¹³⁵ IAM NOOR Eye Care Programme, Afghanistan.
¹³⁶ Department of Clinical Genetics and Center for Rare Disorders, Aarhus University Hospital, Aarhus, Denmark.
¹³⁷ National Cancer Institute, Rio de Janeiro, Brazil.
¹³⁸ Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo.
¹³⁹ National Cancer Institute, Maharagama, Sri Lanka.
¹⁴⁰ Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey.
¹⁴¹ Bai Jerbai Wadia Hospital for Children, Mumbai, India.
¹⁴² King George's Medical University, Lucknow, India.
¹⁴³ Retinoblastoma Referral Center, University of Siena, Siena, Italy.
¹⁴⁴ Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada.
¹⁴⁵ The Indus Hospital, Karachi, Pakistan.
¹⁴⁶ Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
¹⁴⁷ John A. Moran Eye Center, University of Utah, Salt Lake City.
¹⁴⁸ Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
¹⁴⁹ Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan.
¹⁵⁰ University Children's Hospital, Bratislava, Slovakia.
¹⁵¹ Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.
¹⁵² Pediatric Hematology and Oncology Center, Mohammed V University, Rabat, Morocco.
¹⁵³ Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia.
¹⁵⁴ Byers Eye Institute, Stanford University, Stanford, California.
¹⁵⁵ Emory Eye Center, Atlanta, Georgia.
¹⁵⁶ Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
¹⁵⁷ Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
¹⁵⁸ Pacific International Hospital, Port Moresby, Papua New Guinea.
¹⁵⁹ Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.
¹⁶⁰ Fight Against Angiogenesis-Related Blindness Laboratory, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
¹⁶¹ Clínica Oftalmológica Pasteur, Santiago, Chile.
¹⁶² Storm Eye Institute, Medical University of South Carolina, Charleston.
¹⁶³ Bukavu Eye Clinic, Bukavu Official University, Bukavu, Democratic Republic of the Congo.
¹⁶⁴ Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India.
¹⁶⁵ Department of Ophthalmology, Makerere University College of Health Sciences Kamplala, Uganda.
¹⁶⁶ Division of Pediatric Oncology, School of Medicine, Ege University, Izmir, Turkey.
¹⁶⁷ Chang Gung Memorial Hospital, Taipei, Taiwan.
¹⁶⁸ Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia.
¹⁶⁹ Division of Pediatric Hematology-Oncology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine and Oncology Institute, Istanbul University, Istanbul, Turkey.
¹⁷⁰ St. Anne's University Hospital Brno, Masaryk University, and International Clinical Research Center/St Anna University Hospital, Brno, Czech Republic.
¹⁷¹ Dhaka Medical College Hospital, Dhaka, Bangladesh.
¹⁷² Department of Ophthalmology, Postgraduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
¹⁷³ Angkor Hospital for Children, Krong Siem Reap, Cambodia.
¹⁷⁴ Duke Eye Center, Duke University Hospital, Durham, North Carolina.
¹⁷⁵ Sankara Nethralaya, Chennai, India.
¹⁷⁶ Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea.
¹⁷⁷ Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey.
¹⁷⁸ Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
¹⁷⁹ East Tallinn Central Hospital, Tallinn, Estonia.
¹⁸⁰ Oncologue Pédiatre Responsable d'Unité de Bangui, Bangui, Central African Republic.
¹⁸¹ Children's Ophthalmology Department, Children's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania.
¹⁸² Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
¹⁸³ Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand.
¹⁸⁴ University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹⁸⁵ Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁸⁶ Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia.
¹⁸⁷ Clinical Center of Vojvodina, University Eye Clinic, Eye Research Foundation Vidar-Latinović, Novi Sad, Serbia.
¹⁸⁸ Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
¹⁸⁹ John A. Burns School of Medicine, University of Hawaii, Honolulu, and University of Southern California Roski Eye Institute, Los Angeles.
¹⁹⁰ Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
¹⁹¹ Phoenix Children's Hospital, Phoenix, Arizona.
¹⁹² Affiliated Hospital of Dali University, Dali City, China.
¹⁹³ Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
¹⁹⁴ Singapore National Eye Center, Singapore, Singapore.
¹⁹⁵ Ophthalmology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
¹⁹⁶ University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, Democratic Rrepublic of Congo.
¹⁹⁷ Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora.
¹⁹⁸ Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia.
¹⁹⁹ Okhmatdyt National Children's Hospital, Kiev, Ukraine.
²⁰⁰ Pediatric Hematology-Oncology Unit, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India.
²⁰¹ Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe.
²⁰² National Center of Oncology and Hematology, Bishkek, Kyrgyzstan.
²⁰³ University of Alabama at Birmingham, Birmingham.
²⁰⁴ Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda.
²⁰⁵ Scottish Livingstone Hospital, Molepolole, Botswana.
²⁰⁶ Department of Ocular Oncology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
²⁰⁷ Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
²⁰⁸ MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran.
²⁰⁹ Department of Ophthalmology, Jimma University, Jimma, Ethiopia.
²¹⁰ Centre for Sight, New Delhi, India.
²¹¹ Department of Ophthalmology, University of Padova, Padova, Italy.
²¹² Sankara Eye Hospital, Bangalore, India.
²¹³ Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
²¹⁴ Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan.
²¹⁵ King Hussein Cancer Center, Amman, Jordan.
²¹⁶ Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands.
²¹⁷ Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic.
²¹⁸ Service d'Oncologie Pédiatrique de l'Hôpital Aristide le Dantec, Dakar, Senegal.
²¹⁹ Ministry of Health, Lusaka, Zambia.
²²⁰ Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland.
²²¹ Department of Ophthalmology, Lagos University Teaching Hospital, College of Medicine of the University of Lagos, Lagos, Nigeria.
²²² Abii Specialists Hospital, Bamenda, Cameroon.
²²³ Aditya Jyot Eye Hospital, Mumbai, India.
²²⁴ Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India.
²²⁵ N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus.
²²⁶ Cheikh Anta Diop University, Le Dantec Hospital, Dakar, Senegal.
²²⁷ Child Health Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
²²⁸ Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia.
²²⁹ Ho Chi Minh Eye Hospital, Ho Chi Minh, Vietnam.
²³⁰ Department of Ophthalmology, Calabar Children's Eye Center, University of Calabar Teaching Hospital, Calabar Nigeria.
²³¹ Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh.
²³² Arthur Davison Children's Hospital, Ndola, Zambia.
²³³ CHU Angondje Cancerologie, Libreville, Gabon.
²³⁴ Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora.
²³⁵ Komfo Anokye Teaching Hospital, Kumasi, Ghana.
²³⁶ Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile.
²³⁷ National Ophthalmological Institute of Angola, Luanda, Angola.
²³⁸ H M Diwan Eye Foundation, and Tata Medical Center, Kolkata, India.
²³⁹ Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia.
²⁴⁰ University of British Columbia, Vancouver, British Columbia, Canada.
²⁴¹ University Hospital Center Zagreb, Zagreb, Croatia.
²⁴² Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam.
²⁴³ Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi.
²⁴⁴ Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic.
²⁴⁵ Fundacion Clinica Valle del Lili, Cali, Colombia.
²⁴⁶ Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia.
²⁴⁷ Russian Medical Academy of Postgraduate Education, Moscow, Russia.
²⁴⁸ University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia.
²⁴⁹ Good Shepherd Hospital, Siteki, Swaziland.
²⁵⁰ Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
²⁵¹ Hiwa Cancer Hospital, Sulaymaniyah, Iraq.
²⁵² Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.
²⁵³ Department of Ophthalmology, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico.
²⁵⁴ Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar.
²⁵⁵ Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh.
²⁵⁶ Department of Ophthalmology, Davidoff Center for Oncology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
²⁵⁷ School of Medicine and Dentistry, Korle-Bu Teaching Hospital, University of Ghana, Accra, Ghana.
²⁵⁸ University of Pretoria, Pretoria, South Africa.
²⁵⁹ Federal Medical Center, Yola, Nigeria.
²⁶⁰ Nampula Central Hospital, Nampula, Mozambique.
²⁶¹ Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
²⁶² Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon.
²⁶³ NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, United Kingdom.
²⁶⁴ Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
²⁶⁵ Hospital Dr Manuel Ascencio Villarroel, Cochabamba, Bolivia.
²⁶⁶ Pediatric Hemato-Oncology, Hospital Universitario Infantil La Paz, Madrid, Spain.
²⁶⁷ Hospital Solca Quito, Quito, Ecuador.
²⁶⁸ Mahosot Hospital, Vientiane, Laos.
²⁶⁹ Department of Ophthalmology, Rasool Akram Hospital, Tehran, Iran.
²⁷⁰ Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
²⁷¹ National Institute of Ophthalmology, Dhaka, Bangladesh.
²⁷² East Timor Eye Program, Dili, Timor-Leste.
²⁷³ Tata Memorial Hospital, Mumbai, India.
²⁷⁴ Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
²⁷⁵ Ophthalmology Department, Nouakchott Medical University, Nouakchott, Mauritania.
²⁷⁶ Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
²⁷⁷ Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
²⁷⁸ Casey Eye Institute, Oregon Health & Science University, Portland.
²⁷⁹ Mulago National Referral Hospital, Kampala, Uganda.
²⁸⁰ Department of Ophthalmology, University of Washington, Seattle.
²⁸¹ Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia.
²⁸² Children's Mercy Hospital, Kansas City, Missouri.
²⁸³ Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa.
²⁸⁴ BC Children's Hospital, Vancouver, British Columbia, Canada.
²⁸⁵ Pediatra Hemato-Oncologa, Instituto Oncologico del Oriente Boliviano, Santa Cruz de la Sierra, Bolivia.
²⁸⁶ Henan Children's Hospital, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China.
²⁸⁷ Queen Sirikit National Institute of Child Health, Bangkok, Thailand.
²⁸⁸ Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan.
²⁸⁹ Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic.
²⁹⁰ Africa Institute of Tropical Ophthalmology, Bamako, Mali.
²⁹¹ Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú.
²⁹² University Eye Clinic, Skopje, Macedonia.
²⁹³ National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia.
²⁹⁴ Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil.
²⁹⁵ Kabgayi Eye Unit, Gitarama, Rwanda.
²⁹⁶ Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
²⁹⁷ Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali.
²⁹⁸ Department of Ophthalmology, Faculty of Medicine, Ocular Oncology Service, Istanbul University, Istanbul, Turkey.
²⁹⁹ Université Adam Barka, Abeche, Chad.
³⁰⁰ Division of Pediatric Hematology-Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey.
³⁰¹ Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
³⁰² National Cancer Center of Uzbekistan, Tashkent, Uzbekistan.
³⁰³ Children's Clinical University Hospital, Riga, Latvia.
³⁰⁴ Department of Ophthalmology, Medical University of Graz, Graz, Austria.
³⁰⁵ Jos University Teaching Hospital, Jos, Nigeria.
³⁰⁶ National Eye Center Kaduna, Kaduna, Nigeria.
³⁰⁷ Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
³⁰⁸ Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee.
³⁰⁹ Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand.
³¹⁰ Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
³¹¹ Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
³¹² Kunming Children's Hospital, Kunming, China.
³¹³ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
³¹⁴ Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo.
³¹⁵ Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
³¹⁶ S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia.
³¹⁷ Assistante Hospitalo Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania.
³¹⁸ Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
³¹⁹ Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
³²⁰ Ophthalmology Department, Great Ormond Street Hospital, London, United Kingdom.

PMID: 32105305
PMCID: PMC7047856
DOI: 10.1001/jamaoncol.2019.6716

Global Retinoblastoma Presentation and Analysis by National Income Level

Global Retinoblastoma Study Group et al. JAMA Oncol. 2020.

. 2020 May 1;6(5):685-695.

doi: 10.1001/jamaoncol.2019.6716.

Authors

Affiliations

¹ International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
² The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel.
³ Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco.
⁴ Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria.
⁵ Basra Children's Specialty Hospital, Basra, Iraq.
⁶ National Hospital of Niamey, Niamey, Niger.
⁷ University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria.
⁸ Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
⁹ University of California, San Francisco.
¹⁰ Department of Pediatrics, Banaras Hindu University, Varanasi, India.
¹¹ Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria.
¹² The Children's Hospital and the Institute of Child Health, Lahore, Pakistan.
¹³ RS Dr Wahidin Sudirohusodo, Makassar, Indonesia.
¹⁴ The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
¹⁵ Hawler Medical University, Erbil, Iraq.
¹⁶ Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan.
¹⁷ Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain.
¹⁸ Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq.
¹⁹ Philippine General Hospital, University of the Philippines, Manila, Philippines.
²⁰ College of Medicine, King Saud University, Riyadh, Saudi Arabia.
²¹ Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala.
²² Instituto Cubano de Oftalmología Ramón Pando Ferrer, Marianao, Havana, Cuba.
²³ University of Parakou, Parakou, Benin.
²⁴ St Damien Pediatric Hospital, Port-au-Prince, Haiti.
²⁵ Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
²⁶ Pediatric Oncology Department, National Oncology Center, Sana'a, Yemen.
²⁷ Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
²⁸ University Hospital Center Mother Theresa, Tirana, Albania.
²⁹ Imam Hussein Cancer Center, Karbala, Iraq.
³⁰ St Erik Eye Hospital, Stockholn, Sweden.
³¹ Ibn Al Haitham Teaching Eye Hospital, Baghdad, Iraq.
³² Beira Central Hospital, Beira, Mozambique.
³³ Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya.
³⁴ Oncology Unit, Child's Central Teaching Hospital, Baghdad, Iraq.
³⁵ National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia.
³⁶ Bambino Gesù IRCCS Children's Hospital, Rome, Italy.
³⁷ Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey.
³⁸ Siriraj Hospital, Mahidol University, Bangkok, Thailand.
³⁹ Lighthouse For Christ Eye Centre, Mombasa, Kenya.
⁴⁰ Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
⁴¹ Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar.
⁴² Retina Consultants of Houston, Houston, Texas.
⁴³ Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan.
⁴⁴ Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
⁴⁵ Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland.
⁴⁶ Pediatric Hematology-Oncology Unit, Lausanne University Hospital, Lausanne, Switzerland.
⁴⁷ Hospital Nacional de Niños Dr Carlos Sáenz Herrera, San Jose, Costa Rica.
⁴⁸ Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco.
⁴⁹ Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco.
⁵⁰ Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire.
⁵¹ Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles.
⁵² The Calcutta Medical Research Institute, Kolkata, India.
⁵³ Department of Pediatric Hematology and Oncology, Narayana Health City, Bangalore, India.
⁵⁴ University of the Witwatersrand, Johannesburg, South Africa.
⁵⁵ Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany.
⁵⁶ The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine.
⁵⁷ Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City.
⁵⁸ Hospital das Clínicas da FMUSP, São Paulo, Brazil.
⁵⁹ Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso.
⁶⁰ Institut Hédi Raïs d'Ophtalmologie, Faculté de Médecine, Université Tunis El Manar, Tunis, Tunisia.
⁶¹ Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria.
⁶² Solid Tumor Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
⁶³ Cliniques Universitaires Saint-Luc, Brussel, Belgium.
⁶⁴ Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua.
⁶⁵ Hospital del Niño Dr. Francisco De Icaza Bustamante, Guayaquil, Ecuador.
⁶⁶ Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia.
⁶⁷ Salud Ocular, Ministerio de Salud Publica, Asuncion, Paraguay.
⁶⁸ Our Lady's Children's Hospital, Dublin, Ireland.
⁶⁹ Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France.
⁷⁰ Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal.
⁷¹ Hospital Pereira Rossell, Montevideo, Uruguay.
⁷² Hospital Sant Joan de Déu, Barcelona, Spain.
⁷³ Hospital Garrahan, Buenos Aires, Argentina.
⁷⁴ NationalScientific and Technical Research Council, CONICET, Buenos Aires, Argentina.
⁷⁵ Paediatric Ophthalmology Department, Mayo Hospital and College of Allied Visual Sciences, King Edward Medical University, Lahore, Pakistan.
⁷⁶ Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India.
⁷⁷ University of Louisville, Louisville, Kentucky.
⁷⁸ Ocular Oncology Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
⁷⁹ Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria.
⁸⁰ Muhimbili National Hospital, Dar es Salaam, Tanzania.
⁸¹ National Center for Maternal and Children Health of Mongolia, Ulaanbaatar, Mongolia.
⁸² Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland.
⁸³ Starship Children's Health, Auckland, New Zealand.
⁸⁴ Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania.
⁸⁵ Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, and University of Cincinnati College of Medicine, Cincinnati, Ohio.
⁸⁶ Indiana University Medical Center, Indianapolis.
⁸⁷ Bustamante Hospital for Children, Kingston, Jamaica.
⁸⁸ Semmelweis University, Budapest, Hungary.
⁸⁹ Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁹⁰ Quelimane Central Hospital, Quelimane, Mozambique.
⁹¹ Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand.
⁹² Department of Pediatric Hematology-Oncology, Tata Medical Center, Kolkata, India.
⁹³ Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India.
⁹⁴ Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
⁹⁵ Red Cross War Memorial Children's Hospital and the University of Cape Town, Cape Town, South Africa.
⁹⁶ National Children's Hospital, Panama City, Panama.
⁹⁷ Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor.
⁹⁸ Institut Curie, Paris, France.
⁹⁹ Instituto Nacional de Enfermedades Neoplasicas, Lima, Perú.
¹⁰⁰ The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁰¹ Department of Paediatrics, University of Otago, Christchurch, Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand.
¹⁰² The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
¹⁰³ Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil.
¹⁰⁴ Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
¹⁰⁵ University of KwaZulu-Natal, Durban, South Africa.
¹⁰⁶ Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia.
¹⁰⁷ Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia.
¹⁰⁸ Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia.
¹⁰⁹ Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia.
¹¹⁰ Children's Cancer Hospital Egypt 57357, Cairo, Egypt.
¹¹¹ Department of Oncology, National Cancer Institute, University of Gezira, Wadi Madani, Sudan.
¹¹² Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
¹¹³ Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon.
¹¹⁴ Aga Khan University, Karachi, Pakistan.
¹¹⁵ Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran.
¹¹⁶ Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Nigeria.
¹¹⁷ Mi Clinic, Ciudad del Este, Paraguay.
¹¹⁸ Hospital Universitario Virgen Macarena, Sevilla, Spain.
¹¹⁹ Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
¹²⁰ Hospital Escuela, Tegucigalpa, Honduras.
¹²¹ Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador.
¹²² Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi.
¹²³ ClínicaAnglo American, Lima, Perú.
¹²⁴ Servicio Andaluz de Salud, Sevilla, Spain.
¹²⁵ Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
¹²⁶ Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
¹²⁷ Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
¹²⁸ Murray Ocular Oncology and Retina, Miami, Florida.
¹²⁹ Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹³⁰ Department of Ophthalmology, Sourasky Medical Center Tel Aviv, School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹³¹ Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
¹³² Hospital Civil de Guadalajara, Guadalajara, Mexico.
¹³³ Pediatric Oncology Unit, Instituto Regional de Enfermedades Neoplásicas del Sur, Arequipa, Perú.
¹³⁴ Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela.
¹³⁵ IAM NOOR Eye Care Programme, Afghanistan.
¹³⁶ Department of Clinical Genetics and Center for Rare Disorders, Aarhus University Hospital, Aarhus, Denmark.
¹³⁷ National Cancer Institute, Rio de Janeiro, Brazil.
¹³⁸ Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo.
¹³⁹ National Cancer Institute, Maharagama, Sri Lanka.
¹⁴⁰ Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey.
¹⁴¹ Bai Jerbai Wadia Hospital for Children, Mumbai, India.
¹⁴² King George's Medical University, Lucknow, India.
¹⁴³ Retinoblastoma Referral Center, University of Siena, Siena, Italy.
¹⁴⁴ Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada.
¹⁴⁵ The Indus Hospital, Karachi, Pakistan.
¹⁴⁶ Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
¹⁴⁷ John A. Moran Eye Center, University of Utah, Salt Lake City.
¹⁴⁸ Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
¹⁴⁹ Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan.
¹⁵⁰ University Children's Hospital, Bratislava, Slovakia.
¹⁵¹ Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.
¹⁵² Pediatric Hematology and Oncology Center, Mohammed V University, Rabat, Morocco.
¹⁵³ Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia.
¹⁵⁴ Byers Eye Institute, Stanford University, Stanford, California.
¹⁵⁵ Emory Eye Center, Atlanta, Georgia.
¹⁵⁶ Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
¹⁵⁷ Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
¹⁵⁸ Pacific International Hospital, Port Moresby, Papua New Guinea.
¹⁵⁹ Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.
¹⁶⁰ Fight Against Angiogenesis-Related Blindness Laboratory, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
¹⁶¹ Clínica Oftalmológica Pasteur, Santiago, Chile.
¹⁶² Storm Eye Institute, Medical University of South Carolina, Charleston.
¹⁶³ Bukavu Eye Clinic, Bukavu Official University, Bukavu, Democratic Republic of the Congo.
¹⁶⁴ Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India.
¹⁶⁵ Department of Ophthalmology, Makerere University College of Health Sciences Kamplala, Uganda.
¹⁶⁶ Division of Pediatric Oncology, School of Medicine, Ege University, Izmir, Turkey.
¹⁶⁷ Chang Gung Memorial Hospital, Taipei, Taiwan.
¹⁶⁸ Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia.
¹⁶⁹ Division of Pediatric Hematology-Oncology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine and Oncology Institute, Istanbul University, Istanbul, Turkey.
¹⁷⁰ St. Anne's University Hospital Brno, Masaryk University, and International Clinical Research Center/St Anna University Hospital, Brno, Czech Republic.
¹⁷¹ Dhaka Medical College Hospital, Dhaka, Bangladesh.
¹⁷² Department of Ophthalmology, Postgraduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
¹⁷³ Angkor Hospital for Children, Krong Siem Reap, Cambodia.
¹⁷⁴ Duke Eye Center, Duke University Hospital, Durham, North Carolina.
¹⁷⁵ Sankara Nethralaya, Chennai, India.
¹⁷⁶ Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea.
¹⁷⁷ Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey.
¹⁷⁸ Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
¹⁷⁹ East Tallinn Central Hospital, Tallinn, Estonia.
¹⁸⁰ Oncologue Pédiatre Responsable d'Unité de Bangui, Bangui, Central African Republic.
¹⁸¹ Children's Ophthalmology Department, Children's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania.
¹⁸² Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
¹⁸³ Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand.
¹⁸⁴ University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹⁸⁵ Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China.
¹⁸⁶ Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia.
¹⁸⁷ Clinical Center of Vojvodina, University Eye Clinic, Eye Research Foundation Vidar-Latinović, Novi Sad, Serbia.
¹⁸⁸ Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
¹⁸⁹ John A. Burns School of Medicine, University of Hawaii, Honolulu, and University of Southern California Roski Eye Institute, Los Angeles.
¹⁹⁰ Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
¹⁹¹ Phoenix Children's Hospital, Phoenix, Arizona.
¹⁹² Affiliated Hospital of Dali University, Dali City, China.
¹⁹³ Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
¹⁹⁴ Singapore National Eye Center, Singapore, Singapore.
¹⁹⁵ Ophthalmology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
¹⁹⁶ University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, Democratic Rrepublic of Congo.
¹⁹⁷ Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora.
¹⁹⁸ Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia.
¹⁹⁹ Okhmatdyt National Children's Hospital, Kiev, Ukraine.
²⁰⁰ Pediatric Hematology-Oncology Unit, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India.
²⁰¹ Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe.
²⁰² National Center of Oncology and Hematology, Bishkek, Kyrgyzstan.
²⁰³ University of Alabama at Birmingham, Birmingham.
²⁰⁴ Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda.
²⁰⁵ Scottish Livingstone Hospital, Molepolole, Botswana.
²⁰⁶ Department of Ocular Oncology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
²⁰⁷ Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
²⁰⁸ MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran.
²⁰⁹ Department of Ophthalmology, Jimma University, Jimma, Ethiopia.
²¹⁰ Centre for Sight, New Delhi, India.
²¹¹ Department of Ophthalmology, University of Padova, Padova, Italy.
²¹² Sankara Eye Hospital, Bangalore, India.
²¹³ Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
²¹⁴ Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan.
²¹⁵ King Hussein Cancer Center, Amman, Jordan.
²¹⁶ Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands.
²¹⁷ Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic.
²¹⁸ Service d'Oncologie Pédiatrique de l'Hôpital Aristide le Dantec, Dakar, Senegal.
²¹⁹ Ministry of Health, Lusaka, Zambia.
²²⁰ Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland.
²²¹ Department of Ophthalmology, Lagos University Teaching Hospital, College of Medicine of the University of Lagos, Lagos, Nigeria.
²²² Abii Specialists Hospital, Bamenda, Cameroon.
²²³ Aditya Jyot Eye Hospital, Mumbai, India.
²²⁴ Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India.
²²⁵ N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus.
²²⁶ Cheikh Anta Diop University, Le Dantec Hospital, Dakar, Senegal.
²²⁷ Child Health Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
²²⁸ Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia.
²²⁹ Ho Chi Minh Eye Hospital, Ho Chi Minh, Vietnam.
²³⁰ Department of Ophthalmology, Calabar Children's Eye Center, University of Calabar Teaching Hospital, Calabar Nigeria.
²³¹ Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh.
²³² Arthur Davison Children's Hospital, Ndola, Zambia.
²³³ CHU Angondje Cancerologie, Libreville, Gabon.
²³⁴ Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora.
²³⁵ Komfo Anokye Teaching Hospital, Kumasi, Ghana.
²³⁶ Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile.
²³⁷ National Ophthalmological Institute of Angola, Luanda, Angola.
²³⁸ H M Diwan Eye Foundation, and Tata Medical Center, Kolkata, India.
²³⁹ Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia.
²⁴⁰ University of British Columbia, Vancouver, British Columbia, Canada.
²⁴¹ University Hospital Center Zagreb, Zagreb, Croatia.
²⁴² Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam.
²⁴³ Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi.
²⁴⁴ Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic.
²⁴⁵ Fundacion Clinica Valle del Lili, Cali, Colombia.
²⁴⁶ Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia.
²⁴⁷ Russian Medical Academy of Postgraduate Education, Moscow, Russia.
²⁴⁸ University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia.
²⁴⁹ Good Shepherd Hospital, Siteki, Swaziland.
²⁵⁰ Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
²⁵¹ Hiwa Cancer Hospital, Sulaymaniyah, Iraq.
²⁵² Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.
²⁵³ Department of Ophthalmology, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico.
²⁵⁴ Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar.
²⁵⁵ Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh.
²⁵⁶ Department of Ophthalmology, Davidoff Center for Oncology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
²⁵⁷ School of Medicine and Dentistry, Korle-Bu Teaching Hospital, University of Ghana, Accra, Ghana.
²⁵⁸ University of Pretoria, Pretoria, South Africa.
²⁵⁹ Federal Medical Center, Yola, Nigeria.
²⁶⁰ Nampula Central Hospital, Nampula, Mozambique.
²⁶¹ Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
²⁶² Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon.
²⁶³ NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, United Kingdom.
²⁶⁴ Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
²⁶⁵ Hospital Dr Manuel Ascencio Villarroel, Cochabamba, Bolivia.
²⁶⁶ Pediatric Hemato-Oncology, Hospital Universitario Infantil La Paz, Madrid, Spain.
²⁶⁷ Hospital Solca Quito, Quito, Ecuador.
²⁶⁸ Mahosot Hospital, Vientiane, Laos.
²⁶⁹ Department of Ophthalmology, Rasool Akram Hospital, Tehran, Iran.
²⁷⁰ Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
²⁷¹ National Institute of Ophthalmology, Dhaka, Bangladesh.
²⁷² East Timor Eye Program, Dili, Timor-Leste.
²⁷³ Tata Memorial Hospital, Mumbai, India.
²⁷⁴ Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
²⁷⁵ Ophthalmology Department, Nouakchott Medical University, Nouakchott, Mauritania.
²⁷⁶ Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
²⁷⁷ Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
²⁷⁸ Casey Eye Institute, Oregon Health & Science University, Portland.
²⁷⁹ Mulago National Referral Hospital, Kampala, Uganda.
²⁸⁰ Department of Ophthalmology, University of Washington, Seattle.
²⁸¹ Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia.
²⁸² Children's Mercy Hospital, Kansas City, Missouri.
²⁸³ Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa.
²⁸⁴ BC Children's Hospital, Vancouver, British Columbia, Canada.
²⁸⁵ Pediatra Hemato-Oncologa, Instituto Oncologico del Oriente Boliviano, Santa Cruz de la Sierra, Bolivia.
²⁸⁶ Henan Children's Hospital, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China.
²⁸⁷ Queen Sirikit National Institute of Child Health, Bangkok, Thailand.
²⁸⁸ Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan.
²⁸⁹ Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic.
²⁹⁰ Africa Institute of Tropical Ophthalmology, Bamako, Mali.
²⁹¹ Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú.
²⁹² University Eye Clinic, Skopje, Macedonia.
²⁹³ National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia.
²⁹⁴ Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil.
²⁹⁵ Kabgayi Eye Unit, Gitarama, Rwanda.
²⁹⁶ Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
²⁹⁷ Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali.
²⁹⁸ Department of Ophthalmology, Faculty of Medicine, Ocular Oncology Service, Istanbul University, Istanbul, Turkey.
²⁹⁹ Université Adam Barka, Abeche, Chad.
³⁰⁰ Division of Pediatric Hematology-Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey.
³⁰¹ Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
³⁰² National Cancer Center of Uzbekistan, Tashkent, Uzbekistan.
³⁰³ Children's Clinical University Hospital, Riga, Latvia.
³⁰⁴ Department of Ophthalmology, Medical University of Graz, Graz, Austria.
³⁰⁵ Jos University Teaching Hospital, Jos, Nigeria.
³⁰⁶ National Eye Center Kaduna, Kaduna, Nigeria.
³⁰⁷ Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
³⁰⁸ Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee.
³⁰⁹ Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand.
³¹⁰ Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
³¹¹ Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
³¹² Kunming Children's Hospital, Kunming, China.
³¹³ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
³¹⁴ Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo.
³¹⁵ Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
³¹⁶ S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia.
³¹⁷ Assistante Hospitalo Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania.
³¹⁸ Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
³¹⁹ Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
³²⁰ Ophthalmology Department, Great Ormond Street Hospital, London, United Kingdom.

PMID: 32105305
PMCID: PMC7047856
DOI: 10.1001/jamaoncol.2019.6716

Erratum in

Error in Coauthor's Name.
[No authors listed] [No authors listed] JAMA Oncol. 2020 Nov 1;6(11):1815. doi: 10.1001/jamaoncol.2020.5133. JAMA Oncol. 2020. PMID: 32970106 Free PMC article. No abstract available.

Abstract

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale.

Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis.

Design, setting, and participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017.

Main outcomes and measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis.

Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]).

Conclusions and relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Berry reports receiving grants from National Cancer Institute (K08CA232344), Wright Foundation, Knights Templar Eye Foundation, American Cancer Society, Hyundai Hope on Wheels, and Childhood Eye Cancer Trust, as well as nonfinancial support from Institute for Families, The Larry and Celia Moh Foundation, and Research to Prevent Blindness. Dr Correa reports receiving personal fees from Castle Biosciences and Immunocore. Dr Diaz Coronado reports receiving support from Merck Sharp & Dohme. Dr Demirci reports receiving support Castle Biosciences and Immunocore. Dr Foster reports receiving grants from the Queen Elizabeth Diamond Jubilee Trust. Dr Gold reports receiving personal fees from Regeneron. Dr Harbour reports receiving royalties and other support from Castle Biosciences. Dr Hartnett reports receiving grants from the National Eye Institute; having a patent issued and a patent pending related to her work in eye care; receiving honoraria from Wolters Kluwer as editor in chief of the textbook Pediatric Retina Disease, Second Edition; receiving honoraria for academic lectures at the University of Alabama at Birmingham, Michigan State University, University of Florida, University of Iowa, Ohio State University, Indiana University, Cole Eye Institute, Scheie Eye Institute, Massachusetts Eye and Ear, and University of Colorado; and receiving paid trips to consult for the National Eye Institute’s National Advisory Eye Council and for grant review for the Knights Templar Eye Foundation. Dr Kivela reports receiving personal fees from Santen. Dr Materin reports receiving personal fees from IDEAYA Biosciences and Castle Biosciences. Dr Nair reports receiving personal fees from HelpMeSee and Carl Zeiss Meditec. Dr Oliver reports receiving grants from Roche. Dr Skalet reports receiving support as a consultant from Castle Biosciences and Immunocore. Dr Soebagjo reports rights to 2 licensed patents. Dr Stahl reports receiving personal fees from Avedro and nonfinancial support from Sydnexis.

Figures

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Comment in

Retinoblastoma management during the COVID-19 pandemic: A report by the Global Retinoblastoma Study Group including 194 centers from 94 countries.
Fabian ID, Stacey AW, Bowman R, Khetan V, Blum S, Keren-Froim N, Staffieri S, Foster A; Global Retinoblastoma Study Group. Fabian ID, et al. Pediatr Blood Cancer. 2021 Jan;68(1):e28584. doi: 10.1002/pbc.28584. Epub 2020 Aug 6. Pediatr Blood Cancer. 2021. PMID: 32762025 Free PMC article. No abstract available.

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Global Retinoblastoma Presentation and Analysis by National Income Level

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Global Retinoblastoma Presentation and Analysis by National Income Level

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