Toxicity to intravitreal melphalan in a patient with retinoblastoma

Rom J Ophthalmol. 2023 Jul-Sep;67(3):305-308. doi: 10.22336/rjo.2023.49.

Abstract

Objective: Description of melphalan's toxicity in retinoblastoma treatment. Methods: Clinical case report. Results: We presented a case of unilateral retinoblastoma with vitreous seeding at diagnosis, in which the use of intravitreal melphalan produced many adverse reactions. Conclusions: Vitreous seedings have been one of the most important challenges in retinoblastoma treatment. Intravitreal melphalan has achieved the regression of vitreous seedings in a large percentage of cases. It is a safe treatment; however, it can produce toxicity, even with the standard dose of 20-30 µg, which has been poorly documented. Exhaustive follow-up of patients is recommended for an early diagnosis of possible adverse effects. Abbreviations: OS = left eye, RI = magnetic resonance imaging, OCT = optical coherence tomography.

Keywords: hypotonia; intravitreal melphalan; ocular toxicity; phthisis bulbi; retinoblastoma.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents, Alkylating / adverse effects
  • Humans
  • Intravitreal Injections
  • Melphalan / adverse effects
  • Neoplasm Seeding
  • Retinal Neoplasms* / diagnosis
  • Retinal Neoplasms* / drug therapy
  • Retinoblastoma* / diagnosis
  • Retinoblastoma* / drug therapy
  • Retrospective Studies
  • Vitreous Body

Substances

  • Melphalan
  • Antineoplastic Agents, Alkylating