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Intravitreal topotecan in the management of refractory and recurrent vitreous seeds in retinoblastoma
  1. Raksha Rao,
  2. Santosh G Honavar,
  3. Vishal Sharma,
  4. Vijay Anand P Reddy
  1. Department of Ocular Oncology Service, National Retinoblastoma Foundation, Centre for Sight, Hyderabad, India
  1. Correspondence to Dr Santosh G Honavar, National Retinoblastoma Foundation, Ocular Oncology Service, Centre for Sight, Hyderabad, 500034, India; santosh.honavar{at}gmail.com

Abstract

Background/aim To evaluate the efficacy of intravitreal topotecan for refractory or recurrent vitreous seeds in retinoblastoma.

Methods Intravitreal injection of topotecan hydrochloride (30 µg/0.15 mL) was provided every 3 weeks by the safety enhanced technique.

Results The study included 17 consecutive patients with retinoblastoma with refractory or recurrent vitreous seeds. Five eyes (29%) belonged to International Classification of Retinoblastoma group C and 12 eyes (71%) belonged to group D. Primary treatment included triple drug intravenous chemotherapy for a mean of 10 cycles (median, 9 cycles; range, 6–18 cycles). Fifteen patients (88%) had undergone 56 periocular carboplatin injections with a mean of 4 injections (median, 3 injections; range, 1–8 injections), concurrent with intravenous chemotherapy. A total of 53 intravitreal topotecan injections were performed in 17 eyes of 17 consecutive patients with refractory or recurrent vitreous seeds with a mean of 3 injections (median, 3 injections; range, 2–6 injections). Complete regression of vitreous seeds was achieved in 17 of 17 eyes (100%). At a mean follow-up of 23.8 months (median, 24 months; range, 15.1–34.1 months), one eye (6%) with a recurrent retinal tumour needed enucleation, and the rest of the 16 eyes (94%) maintained complete regression. Final visual acuity could be reliably assessed in all 16 eyes (100%), of whom 12 eyes (75%) had visual acuity ≥20/200. None of the patients developed ocular or systemic complications.

Conclusion Three-weekly intravitreal topotecan appears effective and safe in controlling focal or diffuse refractory or recurrent vitreous seeds in retinoblastoma.

  • eye(globe)
  • retina
  • neoplasia
  • treatment other

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Footnotes

  • Contributors All four authors made contributions to conception or design of the work, drafting of the work, revising it critically, approving the final version to be published, and are accountable for all aspects of the work, and ensure the accuracy or integrity of the work. SGH had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests None declared.

  • Ethics approval The Ethics Committee of Centre for Sight, Hyderabad, New Delhi.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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