Intravitreal lower-dose (20 μg) melphalan for persistent or recurrent retinoblastoma vitreous seeds

Tuncer S., Balci Ö., Tanyildiz B., KEBUDİ R., Shields C. L.

Ophthalmic Surgery Lasers and Imaging Retina, vol.46, no.9, pp.942-948, 2015 (SCI-Expanded) identifier identifier identifier


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.