DR. GAURAV GARG

DR MRITTIKA SEN, Dr. SANTOSH G. HONAVAR, Dr.Vijay Anand P. Reddy

Abstract

PURPOSE: Efficacy and safety of tandem intravitreal chemotherapy (Topotecan + Melphalan) for refractory (eyes which had failed monotherapy) vitreous seeds in retinoblastoma.

METHODS: Retrospective interventional case series including 20 eyes of 20 patients, who underwent tandem intravitreal chemotherapy (Topotecan 30µg in 0.05ml + Melphalan 20µg in 0.05ml). Mean number of intravitreal injections were 3.5±1.9 (range 1-7). Regression of vitreous seeds and eye salvage were the primary outcome measures.

RESULTS: Mean age at presentation was 42.6±31.1 months. Mean follow-up was 26.2±18.7 months. Vitreous seeds regression was noted in 17 (85%) eyes with 100% eye salvage. Recurrence of vitreous seeds occurred in 3 eyes, of which 2 were associated with local tumor recurrence. Retinal pigment epithelial alterations were seen in 4 eyes.

CONCLUSION: Tandem intravitreal chemotherapy is highly effective and safe, with impressive regression for refractory vitreous seeds in retinoblastoma.

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