Supplementary Material for: Intracameral Chemotherapy (Melphalan) for Aqueous Seeding in Retinoblastoma: Bicameral Injection Technique and Related Toxicity in a Pilot Case Study
Munier F.L.
Gaillard M.-C.
Decembrini S.
Bongiovanni M.
Beck-Popovic M.
10.6084/m9.figshare.4499123.v1
https://karger.figshare.com/articles/media/Supplementary_Material_for_Intracameral_Chemotherapy_Melphalan_for_Aqueous_Seeding_in_Retinoblastoma_Bicameral_Injection_Technique_and_Related_Toxicity_in_a_Pilot_Case_Study/4499123
<p><b><i>Background:</i></b> The anterior chamber has been shown by
pharmacokinetic studies to represent a sanctuary never achieving a
tumoricidal dose with the present administration routes, such as
systemic, intra-arterial, or intravitreal injections. <b><i>Method:</i></b>
A novel intracameral chemotherapy technique is described to control
aqueous seeding in a pilot unilateral group E retinoblastoma case with
primary aqueous seeding. Anterior segment toxicity was carefully
monitored. <b><i>Results:</i></b> Control of the retinal tumor and
vitreous seeding was achieved by intra-arterial and intravitreal
chemotherapies. Sterilization of the aqueous was achieved after a first
cycle of 7 melphalan injections in the anterior chamber, but relapse was
noted 3.5 months later. This relapse was finally controlled with a
second cycle of 6 intracameral injections targeting the posterior
chamber. Corneal endothelial cell density remained stable over the
injection period. Heterochromia and a progressive cataract developed,
which required cataract surgery. At 5 years' follow-up, the patient is
tumor free with normal vision (20/20 in both eyes), full binocularity,
and no metastasis. <b><i>Conclusions:</i></b> The present bicameral
injection technique appears to be safe and effective with limited
toxicity. Melphalan-induced side effects were noted on the iris and lens
but with no impact on the final visual function.</p>
2016-12-28 13:19:30
Anterior chamber fluid
Chemotherapy
Intravitreal injection
Pathology of the anterior segment
Retinoblastoma
Aqueous seeding
Intracameral chemotherapy
Melphalan