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Selective ophthalmic arterial injection of melphalan for intraocular retinoblastoma: a 4-year review

  • Clinical Investigation
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Abstract

Purpose

To describe tumor response and complications after selective ophthalmic arterial injection (SOAI) of melphalan for treatment of intraocular retinoblastoma.

Methods

A retrospective review of 17 eyes (12 patients) treated with SOAI of melphalan from January 2010 through December 2013 at Chang Gung Memorial Hospital.

Results

SOAI was successfully performed in 49 of 54 attempts. Six eyes underwent SOAI as the primary treatment and 11 eyes had previously been treated with other treatment modalities. Subsequent to SOAI, tumor regression was observed in 12 of 17 eyes, and vitreous seeding with complete or partial regression in ten of 15 eyes. Globe salvage was achieved in ten of 17 eyes, with three of four in group B and group C eyes, and seven of 13 in group D and group E eyes. Pancytopenia accompanied by neutropenic fever was observed in one case. Twelve eyes had local side effects, including lid edema (two eyes), third cranial nerve palsy (two eyes), sixth cranial nerve palsy (one eye), chorioretinal atrophy (six eyes), retinal arterial occlusion (three eyes), retinal detachment (one eye), and vitreous hemorrhage (seven eyes). Three cases with high-risk features, according to the histopathologic examination, had metastatic disease, and two of them died.

Conclusions

SOAI of melphalan is an effective treatment for intraocular retinoblastoma, achieving high globe salvage in cases of advanced disease, but can be associated with significant ocular complications. Repetitive SOAI with delayed enucleation could increase the risk of metastasis when used in high-risk cases. Therefore, clinicians should consider the benefits and potential risks and use this new technique with caution.

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Conflicts of interest

S. J. Ong, None; A. -N. Chao, None; H. -F. Wong, None; K. -L. Liou, None; L. -Y. Kao, None.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan

    Sherine Jue Ong

  2. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taipei, Taiwan

    An-Ning Chao, Kuan-Lyin Liou & Ling-Yuh Kao

  3. Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taipei, Taiwan

    Ho-Fai Wong

Authors
  1. Sherine Jue Ong
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  2. An-Ning Chao
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  5. Ling-Yuh Kao
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Correspondence to Ling-Yuh Kao.

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Cite this article

Ong, S.J., Chao, AN., Wong, HF. et al. Selective ophthalmic arterial injection of melphalan for intraocular retinoblastoma: a 4-year review. Jpn J Ophthalmol 59, 109–117 (2015). https://doi.org/10.1007/s10384-014-0356-y

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  • DOI: https://doi.org/10.1007/s10384-014-0356-y

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