Enucleation in a tertiary eye care centre in India: Prevalence, current indications and clinico-pathological correlation

Abstract

The prevalence of enucleation in the population reporting to this tertiary eye care centre was 33 per 10,000 population over the study period of 3 1/2 years. Major indications for enucleation were tumours, staphyloma and trauma (88% of all cases). Increased frequency in the young was due to the high proportion of retinoblastoma and staphyloma. Childhood trauma, inflammation and malnutrition may together play a role in the pathogenesis of staphyloma. Awareness at the level of primary health care providers, paediatricians and general practitioners should be promoted to identify the disease process at an early stage and facilitate early intervention measures that could result in eye and vision salvage.

Review of 1375 enucleations in the TongRen Eye Centre, Beijing

“…5 Correspondingly, in the study by Vemuganti et al, patients who were enucleated due to ocular trauma were younger than the remaining patients. 6 In contrast to the double-hump distribution of ocular enucleations by age in the present study, Haile from Ethiopia and Sigurdsson et al 4,7 from Iceland found an increasing rate of ocular enucleations with age.The difference between the studies may be caused by variations in the causes of enucleations in the different regions in addition to differences in the socioeconomic background.…”

“…The ratio of retinoblastoma to malignant melanoma was 1.43 : 1. As reported by Vemuganti, 6 the ratio was 9 : 1 in India, in contrast to France and Poland with ratios of 1 : 2 and 1 : 13, respectively. 1,3 The geographical differences in the ratio may reflect a low incidence of malignant melanomas and a relatively high incidence of retinoblastoma in population groups originating closer to the equator.…”

“…6,10 A misdiagnosis of malignant uveal melanoma with a rate of 4%, however, and the percentage of unsuspected malignant uveal melanoma (2.8%) was higher than in reports from Western countries. 11,12 It may suggest that clinical ophthalmologists may be more aware of the masquerade syndrome some malignant uveal melanomas can induce.…”

Enucleation in Iceland 1992–2004: study in a defined population

“…Twothirds of the patients in this study were men, which is the same as in the previous study even though the number of cases was almost fourfold in that study, and the time period of the study was more than twice as long. Other studies have also reported male predominance, 51-71% (Erie et al 1992;de Gottrau et al 1994;Gu¨nalp et al 1997;Hansen et al 1999;Custer & Reistad 2000;Vemuganti et al 2001;Kitzmann et al 2003;Bal et al 2007;Rasmussen et al 2010).…”

“…Most studies on the causes for enucleation and the trends over time are not in a defined population, rather they are limited to tertiary care centres or reflect the uptake area and the specialty service eye hospitals have to offer (de Gottrau et al 1994;Gu¨nalp et al 1997;Hansen et al 1999;Custer & Reistad 2000;Vemuganti et al 2001;Bal et al 2007;Rasmussen et al 2010). The benefit of a study in a defined population is that it is possible to determine the actual incidence in the entire population, which can be extrapolated to other comparable populations.…”