Figure 2: Improvement opportunities - a proposed chain of initiatives based on the review of studies in the countries pointed in the map (Jordan, India, Kenya, Lebanon, Brazil, Nigeria, Honduras, Ethiopia, Peru) and multinational studies. Act 1: International Partnership : Establishing partnerships with the teleconsultation of specialists, mentoring programs, and financial aid to support the development of local programs. Act 2: Nationally Coordinated Programs: Implementing nationally coordinated programs for public assistance, including centralization of care, financial aid from local governments, and educational initiatives. Act 3: Education and Awareness: Develop educational tools for the medical community and general population to increase awareness of the disease, particularly targeting populations at higher risk. Act 4: Screening Programs:Implementing screening programs focused on populations at higher risk, while also incorporating periodic ocular health evaluation for all children. Future considerations include the integration of smartphone applications and algorithms to enhance screening accuracy. Act 5: Genetic Services: Establishing cost-effective genetic screening services to support early detection and diagnosis.

4.2. Limitations and other challenges

Heterogeneity in study types and interventions prevented quantitative analysis. No clinical trials on the subject were found. However, this review emphasizes relevant interventions from observational studies, suggesting their potential evaluation in experimental settings to improve outcome confidence. However, numerous other barriers to early diagnosis and treatment access, such as medical care abandonment, diagnostic errors, referral delays, geographic distance from health facilities, and challenges related to treatment toxicity were not addressed here.

CONCLUSION

Most LMICs lack adequate diagnosis and treatment programs specifically tailored for RB. It is crucial to identify the specific deficiencies and gaps in care within each country to implement the suggested acts in a customized manner. This study provides indirect evidence of interventions that may contribute to improving survival rates and preserving vision in patients with RB, but these findings should be corroborated through appropriately designed studies.