Anterior ocular toxicity of intravitreous melphalan for retinoblastoma Journal Article


Authors: Francis, J. H.; Marr, B. P.; Brodie, S. E.; Abramson, D. H.
Article Title: Anterior ocular toxicity of intravitreous melphalan for retinoblastoma
Abstract: IMPORTANCE Intravitreous injections of melphalan hydrochloride are increasingly used in the treatment of vitreous seeding of retinoblastoma. Although this technique can save eyes otherwise destined for enucleation, ocular salvagemay be accompanied by local toxic effects. Posterior segment toxic effects in this context are well established. This report describes the toxic effects on the anterior segment following intravitreous administration of melphalan. OBSERVATIONS Our clinic cohort included 76 patients who received intravitreous injections of melphalan at Memorial Sloan Kettering Cancer Center from September 12, 2012, through April 15, 2015; data analysis was performed from April 15 through May 15, 2015.We report a series of 5 patients from this cohort who developed anterior segment toxic effects. These abnormalities were found at the injection site or within the meridian of the injection and included a traumatic cataract following an injection at an outside hospital, iris depigmentation and thinning, iris recession with retinal necrosis and hypotony, a filtering conjunctival bleb, and focal scleromalacia with localized pigmentation. CONCLUSIONS AND RELEVANCE Intravitreous injection of melphalan may result in toxic effects on the anterior segment of the eye, in addition to retinal abnormalities, and appears to be more common in the meridian of the injection where the drug concentration is highest. © 2015 American Medical Association. All rights reserved.
Journal Title: JAMA Ophthalmology
Volume: 133
Issue: 12
ISSN: 2168-6165
Publisher: American Medical Association  
Date Published: 2015-12-01
Start Page: 1459
End Page: 1463
Language: English
DOI: 10.1001/jamaophthalmol.2015.3119
PROVIDER: scopus
PUBMED: 26378741
PMCID: PMC4979541
DOI/URL:
Notes: Article -- Export Date: 2 June 2016 -- Source: Scopus
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MSK Authors
  1. Brian Marr
    112 Marr
  2. Jasmine Helen Francis
    256 Francis
  3. David H Abramson
    389 Abramson
  4. Scott Brodie
    38 Brodie