title: Intravitreal Lower-Dose (20 µg) Melphalan for Persistent or Recurrent Retinoblastoma Vitreous Seeds.
abstract: OBJECTIVE
  The major cause of failure in the management of retinoblastoma is the persistence/recurrence of vitreous seeds (VS). This study reports the efficacy and complications of standard lower-dose (20 µg) intravitreal melphalan for VS.
  
  
  METHODS
  Retrospective review of all patients with active VS treated with lower-dose intravitreal melphalan (20 µg/0.1 mL) on a monthly basis until complete VS regression was achieved.
  
  
  RESULTS
  A total of 14 injections were delivered to seven eyes of seven patients (range: 1-4; median: 2). At a median follow-up of 20 months (range: 12-32 months), complete regression of VS was achieved in all cases (100%), and globe salvage was achieved in six cases (86%). One eye required enucleation for solid tumor recurrence. Side effects of retinal pigment epithelium mottling at the site of injection was noted in two eyes (29%).
  
  
  CONCLUSIONS
  The 2-year results of this study suggest that standard lower-dose (20 µg) intravitreal melphalan is safe and highly effective for the management of viable VS from retinoblastoma.
authors.forename: Samuray
authors.initials: S
authors.lastname: Tuncer
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Balcı
authors.forename: Burak
authors.initials: B
authors.lastname: Tanyıldız
authors.forename: Rejin
authors.initials: R
authors.lastname: Kebudi
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D058449:Intravitreal Injections; D008297:Male; D008558:Melphalan / Q000008:administration & dosage*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009366:Neoplasm Seeding; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012175:Retinoblastoma / Q000188:drug therapy* / Q000556:secondary; D012189:Retrospective Studies; D014822:Vitreous Body / Q000187:drug effects* / Q000473:pathology
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan