The prevalence and pattern of ocular and orbital tumours in patients attending mulago hospital eye department

Abstract

BACKGROUND: Ocular and orbital tumours present a lot of management problems. Patients over stay in hospital while undergoing a process of making a diagnosis and the treatment that follows. These tumours are associated with a high morbidity and mortality rate and patients usually present with late stages of the disease ending up with disfiguring operations like exenteration. Despite the increasing number of patients with ocular and orbital tumours presenting to mulago hospital eye department, there is scanty information concerning the magnitude of the problem, AIM: To determine the prevalence, pattern and distribution of ocular and orbital tumours in patients attending mulago hospital eye department so as to improve on their management. OBJECTIVES: 1. To determine the prevalence of ocular and orbital tumours in patients attending mulago hospital eye department. 2. To establish age, sex and geographical distribution of patients with ocular and orbital tumours attending mulago hospital eye department 3. To establish the histological types of ocular and orbital tumours in patients attending mulago hospital eye department METHODS AND MATERIALS: This was an eight months hospital based descriptive cross sectional study of patients attending mulago hospital eye department, carried out between February 2008 and October 2008. Patients with ocular and orbital tumours were recruited. History, clinical examination and investigations were done. Excision or incisional biopsy tissues were taken off and fixed in 10% formal saline for histological examination. Data collected was analysed with respect to study variables. RESULTS: The prevalence of ocular and orbital tumours among patients who presented to the eye department was 1.4%. The prevalence of ocular and orbital tumours in children was 1% and 1.6% in adults. One hundred fifty two patients with ocular and orbital tumours were seen, their mean age was28.9 years, median of 29 years and the age range was one year to 83 years. There were 35 children and 117 adults, 55% of the study participants were females and 45% were males. Benign tumours comprised of 49.5% while the remainder malignant tumours. Malignancy occurred at an early (0-4 years) and picked in the 3rd decade. Most of childhood tumours were malignant (80%) as compared to 41.9% in adults. Retinoblastoma (42.9%) was the most common tumour in children followed by Burkitt’s lymphoma (25.7%, dermoid cysts (11.4%), Non Hodgkin lymphoma and rhabdomyosarcoma (5.7% each), pleomorphic adenoma, carvenous haemangioma and diktyoma (2.9% each). Solar keratosis of the conjunctiva (38.5%) was the most common tumour in adults, followed by squamous cell carcinoma of the conjunctiva (26.5%), carcinoma in situ of conjunctiva (10.3%), epithelial dysplasia of conjunctiva (6%), dermoid cysts (4.3%), papillomatosis (2.6%), squamous cell dysplasia of conjunctiva (2.6%), Kaposi’s sarcoma, pleomorphic adenoma and epidermoid cysts (1.7% each), Burkitt’s lymphoma, malignant lacrimal tumour, multiple myeloma and fibrosarcoma (0.9% each). Blindness was noticed in 14.8% of the affected eyes and 21.8% had eye ball removal due to ocular and orbital tumours.

CONCLUSIONS: The prevalence of ocular and orbital tumours among patients who presented to eye department was 1.4%. The distribution of ocular and orbital tumours showed two peaks, the first one occurring between 0-4 years mainly contributed by retinoblastoma and the second at 125-34 years due to squamous cell carcinoma and solar keratosis. The most common tumours in children were retinoblastoma, followed by burkitt’s lymphoma and dermoid cysts while solar keratosis followed by squamous cell carcinoma, carcinoma in situ and dermoid cysts were the most common in adults. Distribution of tumours in both sexes was almost similar.