Intravitreal Lower-Dose (20 µg) Melphalan for Persistent or Recurrent Retinoblastoma Vitreous Seeds.

Abstract

BACKGROUND AND OBJECTIVE:

The major cause of failure in the management of retinoblastoma is the persistence/recurrence of vitreous seeds (VS). This study reports the efficacy and complications of standard lower-dose (20 µg) intravitreal melphalan for VS.

PATIENTS AND METHODS:

Retrospective review of all patients with active VS treated with lower-dose intravitreal melphalan (20 µg/0.1 mL) on a monthly basis until complete VS regression was achieved.

RESULTS:

A total of 14 injections were delivered to seven eyes of seven patients (range: 1-4; median: 2). At a median follow-up of 20 months (range: 12-32 months), complete regression of VS was achieved in all cases (100%), and globe salvage was achieved in six cases (86%). One eye required enucleation for solid tumor recurrence. Side effects of retinal pigment epithelium mottling at the site of injection was noted in two eyes (29%).

CONCLUSION:

The 2-year results of this study suggest that standard lower-dose (20 µg) intravitreal melphalan is safe and highly effective for the management of viable VS from retinoblastoma.

• Authors: Samuray Tuncer, Özlem Balcı, Burak Tanyıldız, Rejin Kebudi, Carol L Shields
• Journal: Ophthalmic surgery, lasers & imaging retina (Ophthalmic Surg Lasers Imaging Retina) Vol. 46 Issue 9 Pg. 942-8 (Oct 2015) ISSN: 2325-8179 [Electronic] United States
• PMID: 26469234 (Publication Type: Journal Article)
• Copyright: Copyright 2015, SLACK Incorporated.

Chemical References

• Antineoplastic Agents, Alkylating
• Melphalan

Topics

• Antineoplastic Agents, Alkylating (administration & dosage)
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Intravitreal Injections
• Male
• Melphalan (administration & dosage)
• Neoplasm Recurrence, Local (drug therapy)
• Neoplasm Seeding
• Retinal Neoplasms (drug therapy, pathology)
• Retinoblastoma (drug therapy, secondary)
• Retrospective Studies
• Vitreous Body (drug effects, pathology)