title: Pathological findings in enucleated eyes after intravitreal melphalan injection.
abstract: The aim of this study is to evaluate the pathological findings of the eye after intravitreal melphalan for viable vitreous seeding from retinoblastoma. All enucleated eyes receiving an intravitreal injection of melphalan (10-50 μg in 0.05 cc) were evaluated for histological changes. Of 25 treated cases, 8 eyes needed enucleation because of phthisis, parent request, or new tumor development. One of the cases was excluded from the study because of a history of intra-arterial chemotherapy with melphalan. There was no case of needle-site scleral involvement by retinoblastoma cells. In two eyes receiving 50 μg melphalan, no viable retinoblastoma cell was detectable in the eye. Severe gliosis, vascular occlusion, retinal necrosis, hemorrhage and neovascularization were seen. Histologically, intravitreal melphalan for recalcitrant or recurrent vitreous seeds from retinoblastoma appears to provide acceptable vitreous seed control. It seems that higher doses could be destructive causing ischemic necrosis in the retina, severe gliosis and secondary neovascular changes as well as having a destructive effect on retinoblastoma cells.
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar, 1336616351, Tehran, Islamic Republic of Iran, fariba.ghassemi@gmail.com.
authors.forename: Fariba
authors.initials: F
authors.lastname: Ghassemi
authors.forename: Fahimeh Asadi
authors.initials: FA
authors.lastname: Amoli
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D002675:Child, Preschool; D015353:Eye Enucleation; D006801:Humans; D007223:Infant; D058449:Intravitreal Injections; D008558:Melphalan / Q000008:administration & dosage*; D009366:Neoplasm Seeding; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary / Q000601:surgery; D012175:Retinoblastoma / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary / Q000601:surgery; D012189:Retrospective Studies; D014822:Vitreous Body / Q000473:pathology*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan
references.citation: Br J Ophthalmol. 2012 Aug;96(8):1078-83
references.pmid: 22694968
references.citation: Arch Ophthalmol. 2011 Nov;129(11):1416-21
references.pmid: 21746972
references.citation: Arch Ophthalmol. 2012 Jun;130(6):724-9
references.pmid: 22801832
references.citation: Retina. 2011 Mar;31(3):566-73
references.pmid: 21273941
references.citation: Arch Ophthalmol. 2003 Aug;121(8):1125-31
references.pmid: 12912690
references.citation: Retina. 2000;20(1):33-6
references.pmid: 10696744
references.citation: Ophthalmology. 1993 Feb;100(2):216-24
references.pmid: 8437830
references.citation: Arch Ophthalmol. 2011 Nov;129(11):1399-406
references.pmid: 21670328
references.citation: Arch Ophthalmol. 2010 Dec;128(12):1619-23
references.pmid: 21149791
references.citation: Nippon Ganka Gakkai Zasshi. 1995 Nov;99(11):1230-5
references.pmid: 8533651
references.citation: Acta Ophthalmol (Copenh). 1961;39:569-76
references.pmid: 13890561
references.citation: Jpn J Cancer Res. 1987 Aug;78(8):858-68
references.pmid: 3115934
references.citation: Ophthalmology. 2006 Dec;113(12):2276-80
references.pmid: 16996605
references.citation: Br J Ophthalmol. 2011 Apr;95(4):553-8
references.pmid: 20693555
references.citation: Arch Ophthalmol. 2012 Oct;130(10):1268-71
references.pmid: 23044940
references.citation: Ophthalmology. 2011 Aug;118(8):1689, 1689.e1-6
references.pmid: 21813093
references.citation: Clin Ophthalmol. 2011;5:1655-8
references.pmid: 22174572
references.citation: Arch Ophthalmol. 1981 Oct;99(10):1763-6
references.pmid: 7295123
references.citation: Open Ophthalmol J. 2011 Jan 18;5:1-5
references.pmid: 21399766
references.citation: Arch Ophthalmol. 1998 Jul;116(7):887-93
references.pmid: 9682701
references.citation: Ophthalmology. 2008 Aug;115(8):1398-404, 1404.e1
references.pmid: 18342944
references.citation: Acta Ophthalmol (Copenh). 1964;42(4):721-6
references.pmid: 4966433
references.citation: Invest Ophthalmol Vis Sci. 2012 Apr 30;53(4):2439-45
references.pmid: 22427570