Ilorin retinoblastoma workshop, December 2018

Last week, I had the privilege of helping out at a two-day workshop on retinoblastoma. The workshop was held at the University of Ilorin Teaching Hospital in Nigeria and organised by Consultant Ophthalmologist Dr Dupe Ademola-Popoola. It was supported by VISION 2020 LINKS, the London School of Hygiene and Tropical Medicine, and Rb-NET funded by the Queen Elizabeth Diamond Jubilee Trust. Three of us travelled over from London: Paediatric Ophthalmologist Mr Ashwin Reddy and Oncology Nurse Ms Charlotte Clifton, as well as myself.

Charlotte and Ashwin outside the lecture theatre

I believe this was the first ever retinoblastoma meeting held in the country, with attendees from all over Nigeria as well as a few from Ghana. The meeting brought together delegates from medical and nursing disciplines including: ophthalmology, oncology, paediatrics and pathology. The overall intention of the meeting was to share knowledge and experiences about this serious but curable disease, and to offer support and ideas to practitioners facing challenges within their own organisations.

The programme was comprehensive, with separate practical sessions for the nurses and pathologists. Whole-group topics included clinical aspects such as genetics, presentation, examination, management options and chemotherapy regimes. This last-mentioned talk was delivered by Dr Enrico Opocher, Consultant Oncologist, via video link.

Other discussion topics were broader, such as how to support families, encourage early screening or raise public (and clinical) awareness. On the one hand, the disease is so rare that a general healthcare practitioner may never come across it; on the other, it is curable if detected early and fatal if detected late.

During a particularly valuable session, participants shared specific challenges they were facing with retinoblastoma care. These challenges might include funding, lack of communication or ill-defined pathways. Of course, a two-day meeting couldn’t solve everyone’s problems on the spot, but I got a distinct impression that the conversations started would continue beyond the confines of the meeting room. Everyone seemed to appreciate that the meeting is the start of a process, not a one-stop solution.

I ran a couple of separate pathology sessions for the Ilorin histopathologists. The first covered macroscopic evaluation of eye specimens (globes and exenterations), from orientation to retinoblastoma-specific features (such as calcification or optic nerve expansion). The second session on microscopy started with ophthalmic histology and continued on through retinoblastoma, involvement of different ocular structures, secondary findings (such as rubeosis) and potential mimics. I’d like to thank Olaleke, Ali, Joshua, Adekunle and Idris for making me feel so welcome.

Outside the pathology department
One of the cases we discussed

It was a pleasure to meet everyone at the workshop, and we are immensely grateful to all those who helped with the logistics of our trip.

When I arrived home, I was delighted to receive my copy of the recently published WHO Classification of Tumours of the Eye, 4th edition. I would recommend it to any pathologist who deals with eye tumours – and I’m not just saying that because I contributed!

Links to various references below:

WHO Classification of Tumours of the Eye (available for purchase, discount for developing countries)

Royal College of Pathologists 2018 retinoblastoma dataset (free access)

Community Eye Health Journal article on histological high-risk features in retinoblastoma (free access)

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