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Intravitreal chemotherapy in retinoblastoma: expanded use beyond intravitreal seeds
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  • Published on:
    Response to Letter to the Editor
    • Larissa A Habib, MD Massachusetts Eye and Ear Infirmary
    • Other Contributors:
      • David H. Abramson, MD
      • Jasmine H. Francis, MD
      • Federica Catalanotti, PhD
      • Scott E Brodie, MD
      • Xunda Ji, MD

    To the editor and auther Kivela et al.:

    We thank the authors of the article “Intravitreal Methotrexate for Retinoblastoma” published in Ophthalmology in 2011 for their letter to the editor and adjustment of our discussion in our paper. As was found in your experience, as well as ours, intravitreal chemotherapy plays an important role in the treatment of retinoblastoma outside of its currently accepted use for intravitreal seeds. We look forward to hearing about your continued successful experience with intravitreal melphalan for use beyond intravitreal seeds.

    Conflict of Interest:
    None declared.
  • Published on:
    Intravitreal chemotherapy in non-vitreal retinoblastoma
    • Tero T. Kivelä, Professor and Chair University of Helsinki and Helsinki University Hospital
    • Other Contributors:
      • Sebastian Eskelin, Consultant Ophthalmologist

    In their report, entitled “Intravitreal chemotherapy in retinoblastoma: expanded use beyond intravitreal seeds“, Abramson and corkers report on the successful use of intravitreal chemotherapy in 52 patients for subretinal seeds and recurrent retinal tumours [1]. They state that, prior to their experience, intravitreal chemotherapy had been used exclusively to control persistent or recurrent vitreous seeding in retinoblastoma that had been refractory to systemic intravenous or intra-arterial chemotherapy.

    In fact, intravitreal chemotherapy as an adjuvant treatment for both subretinal seeds and recurrent retinal tumours, including its use instead of systemic chemotherapy in the setting of chemothermotherapy for small unresponsive primary retinoblastomas, has been in regular use already for a decade at the Ocular Oncology Service, Helsinki University Eye Hospital. Indeed, three of the first four patients that we reported during the congress of the International Society of Ocular Oncology in 2009 [2], and published in 2011 [3], received intravitreal methotrexate for reasons other than vitreous seeds. Subsequent experience with intravitreal chemotherapy with methotrexate and, later, with melphalan has strengthened our initial findings, as does the comprehensive report of Abramson and coworkers.

    1. Abramson DH, Ji X, Francis JH, et al. Intravitreal chemotherapy in retinoblastoma: expanded use beyond intravitreal seeds. Br J Ophthalmol 2018 Jun 6. pii: bjophthalmol-...

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    Conflict of Interest:
    None declared.