Anterior Segment Seeding in Eyes With Retinoblastoma Failing to Respond to Intraophthalmic Artery Chemotherapy.
OBJECTIVE
Anterior chamber seeding following intraophthalmic artery chemotherapy is rarely reported.


OBJECTIVE
To describe clinicopathologic observations in eyes in which intraophthalmic artery chemotherapy for retinoblastoma failed and to report anterior chamber involvement.


METHODS
A retrospective case series of 12 enucleated eyes (11 patients) with retinoblastoma refractory to intraophthalmic artery chemotherapy between March 1, 2010, and October 31, 2013, at University College London Institute of Ophthalmology and the Retinoblastoma Service, Royal London Hospital. Data analysis was conducted from June 1, 2014, to March 1, 2015. The International Classification of Retinoblastoma groups were B in 1 eye (8%), C in 4 eyes (33%), and D in 7 eyes (58%). Systemic chemotherapy with vincristine sulfate, etoposide, and carboplatin had failed in 10 patients (91%) and 6 eyes (50%) received additional local treatments. In 6 eyes (50%) anterior chamber invasion was clinically detectable. On histopathologic examination, 4 eyes (33%) had no viable retinal tumor; the remainder had poorly differentiated tumor (6 eyes [50%]) or moderately differentiated tumor (2 eyes [17%]). Anterior segment involvement occurred in the ciliary body and/or ciliary muscle (7 eyes [58%]), iris (6 eyes [50%]), and cornea (4 eyes [33%]).


CONCLUSIONS
Intraophthalmic artery chemotherapy can fail in eyes with retinoblastoma. In contrast to previous reports on outcomes following intraophthalmic artery chemotherapy, our series shows involvement of the anterior segment of the eye, including the ciliary body, iris, and cornea. Careful case selection and follow-up are advised.
Retinoblastoma Service, Royal London Hospital, London, England2Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, England3University College London Institute of Ophthalmology, London, England.
Efthymia
E
Pavlidou
Retinoblastoma Service, Royal London Hospital, London, England.
Christopher
C
Burris
Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, England3University College London Institute of Ophthalmology, London, England.
Caroline
C
Thaung
Pathology Department, Royal London Hospital, London, England.
Irene
I
Scheimberg
Retinoblastoma Service, Royal London Hospital, London, England5Paediatric Oncology Department, Great Ormond Street Hospital, London, England.
Judith
J
Kingston
Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, England.
John L
JL
Hungerford
Retinoblastoma Service, Royal London Hospital, London, England2Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, England.
M Ashwin
MA
Reddy
Retinoblastoma Service, Royal London Hospital, London, England2Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, England3University College London Institute of Ophthalmology, London, England.
Mandeep S
MS
Sagoo
D000293:Adolescent; D000869:Anterior Eye Segment / Q000473:pathology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005047:Etoposide / Q000627:therapeutic use; D015353:Eye Enucleation; D005134:Eye Neoplasms / Q000556:secondary*; D005260:Female; D006801:Humans; D007223:Infant; D007261:Infusions, Intra-Arterial; D008297:Male; D009366:Neoplasm Seeding; D009880:Ophthalmic Artery; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D012175:Retinoblastoma / Q000188:drug therapy / Q000556:secondary*; D012189:Retrospective Studies; D017211:Treatment Failure; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin