Intravitreal melphalan as salvage therapy for refractory retinal and subretinal retinoblastoma Journal Article


Authors: Francis, J. H.; Marr, B. P.; Brodie, S. E.; Gobin, P.; Dunkel, I. J.; Abramson, D. H.
Article Title: Intravitreal melphalan as salvage therapy for refractory retinal and subretinal retinoblastoma
Abstract: Purpose: This case series highlights the novel use of intravitreal melphalan for nonvitreous retinoblastoma. It assesses the efficacy and toxicity of intravitreal melphalan for nonvitreous retinoblastoma. Methods: This observational small case series investigates three patients treated with intravitreal melphalan for nonvitreous retinoblastoma that was refractory to multiple-course ophthalmic artery chemosurgery. Patients' demographics, response to treatment, and toxicity of treatment as clinically evaluated are measured by electroretinogram. Patients: Three eyes of three patients received a median of 7 weekly intravitreal melphalan injections (30 mg/0.07 cc) for persistent retinal or subretinal tumors refractory to treatment with multiple-course ophthalmic artery chemosurgery. Results: Eyes remain tumor free at a median of 14-month follow-up. One eye was enucleated because of a vitreous hemorrhage that obscured fundus details. One eye had extinguished electroretinogram recordings before injections and two eyes had a decrease in electroretinogram responses over the intravitreal treatment course. The eye with subretinal seeding demonstrated marked retinopathy by ophthalmoscopy and fluorescein angiography and one eye was enucleated because of the development of a vitreous hemorrhage. Conclusion: This small case series highlights that nonvitreous disease that is, refractory or persistent despite previous ophthalmic artery chemosurgery can regress with intravitreal melphalan. However, this treatment may result in retinal toxicity. © 2014 Society of Trauma Nurses.
Keywords: chemotherapy; melphalan; retinoblastoma; retina; intravitreal injection
Journal Title: Retinal Cases and Brief Reports
Volume: 10
Issue: 4
ISSN: 1935-1089
Publisher: Ophthalmic Communications Society, Inc  
Date Published: 2016-01-01
Start Page: 357
End Page: 360
Language: English
DOI: 10.1097/icb.0000000000000262
PROVIDER: scopus
PMCID: PMC4917462
PUBMED: 26630243
DOI/URL:
Notes: Article -- Export Date: 2 November 2016 -- Source: Scopus
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MSK Authors
  1. Brian Marr
    112 Marr
  2. Ira J Dunkel
    371 Dunkel
  3. Jasmine Helen Francis
    256 Francis
  4. David H Abramson
    389 Abramson
  5. Scott Brodie
    38 Brodie
  6. Pierre Gobin
    25 Gobin