title: Intraocular Pressure Changes Following Intravitreal Melphalan and Topotecan for the Treatment of Retinoblastoma With Vitreous Seeding.
abstract: OBJECTIVE
  To investigate the impact of intravitreal chemotherapy on intraocular pressure (IOP) in children with retinoblastoma.
  
  
  METHODS
  This was a retrospective study of 10 eyes of 10 patients with retinoblastoma (7 males, 3 females, mean age: 33.6 ± 9.4 months) with vitreous seeding injected with intravitreal melphalan and topotecan. IOP was measured with Tonopen (Reichert, Inc., Buffalo, NY) at baseline prior to injecting and then repeatedly following each intravitreal injection.
  
  
  RESULTS
  Mean pre-injection IOP was 8.2 ± 2.3 mm Hg (range: 4 to 12 mm Hg). Mean IOP 1 to 30 seconds after intravitreal melphalan (first injection) was 45.4 ± 14.3 mm Hg. The IOP of 89.5% of patients declined to 29 mm Hg or less in a mean 153.3 ± 97.5 seconds. Mean IOP 1 to 30 seconds after intravitreal topotecan (second injection) was 44.5 ± 11.0 mm Hg, which decreased to 31.0 ± 5.0 mm Hg by 150 seconds after injection. No significant relationship was found between age and post-injection IOP elevation. IOP exceeded the calculated mean arterial perfusion pressure in four encounters.
  
  
  CONCLUSIONS
  Intravitreal chemotherapy caused a transient rise in IOP. Post-injection IOP elevations can reach levels that may exceed mean arterial pressure. [J Pediatr Ophthalmol Strabismus. 2017;54(3):185-190.].
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Karl
authors.forename: Jasmine H
authors.initials: JH
authors.lastname: Francis
authors.forename: Saipriya
authors.initials: S
authors.lastname: Iyer
authors.forename: Brian
authors.initials: B
authors.lastname: Marr
authors.forename: David H
authors.initials: DH
authors.lastname: Abramson
mesh_terms: D000293:Adolescent; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D058449:Intravitreal Injections; D008297:Male; D008558:Melphalan / Q000008:administration & dosage*; D009366:Neoplasm Seeding; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D012175:Retinoblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary; D012189:Retrospective Studies; D059004:Topoisomerase I Inhibitors / Q000008:administration & dosage; D019772:Topotecan / Q000008:administration & dosage*; D016896:Treatment Outcome; D014822:Vitreous Body / Q000473:pathology*; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D059004:Topoisomerase I Inhibitors; D019772:Topotecan; D008558:Melphalan