Intravitreal chemotherapy in the management of retinoblastoma in a resource-limited setting

African Vision and Eye Health

Field Value
Title Intravitreal chemotherapy in the management of retinoblastoma in a resource-limited setting
Creator Rawjee, Kashmira Seobi, Teboho Makgotloe, Aubrey
Subject ophthalmology; ocular oncology; paediatric oncology retinoblastoma; ocular oncology; intravitreal chemotherapy; vitreous seeds; melphalan; topotecan
Description Intravitreal chemotherapy (IVitC) in the management of retinoblastoma has increased the rate of globe salvage, specifically in patients with recurrent disease and associated vitreous seeds. A significant number of children with retinoblastoma in developing countries present late, resulting in higher intraocular tumour-stage at presentation. Treatment requirements for such tumours usually include intravenous chemotherapy (IVC) and/or intra-arterial chemotherapy (IAC). While IVC has a long usage track record and a good efficacy, it has been reported to be associated with higher recurrence rates in a significant number of patients. Intra-arterial chemotherapy has the advantage of lower recurrence rates but requires personnel with advanced interventional radiology skills and has limited efficacy in treating intravitreal seeds. Intravitreal chemotherapy has gained popularity recently, largely because of its superior efficacy in the management of vitreous seeds, subretinal seeds and recurrent retinal tumour. An 8-month-old male infant initially presented with bilateral retinoblastoma, International Classification System for Intraocular Retinoblastoma (ICRB) Group E in the right eye and Group B on the left eye. The right eye was enucleated and currently has a prosthesis. The left eye had tumours that initially responded to brachytherapy and transpupillary thermotherapy (TTT). Approximately two years later his tumours recurred with vitreous seeds and were successfully managed with the use of cryotherapy and intravitreal chemotherapy. The simplicity of the technique of IVitC and its efficacy in controlling vitreous seeds and recurrent retinal tumours makes this route of regional chemotherapy a viable one in areas with limited expertise and resources such as South Africa.
Publisher AOSIS
Contributor University of the Witwatersrand Charlotte Maxeke Johannesburg Academic Hospital
Date 2022-01-11
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Case report
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/aveh.v81i1.692
Source African Vision and Eye Health; Vol 81, No 1 (2022); 4 pages 2410-1516 2413-3183
Language eng
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Coverage Gauteng; South Africa 2016-2021 child; male; African black
Rights Copyright (c) 2022 Kashmira Rawjee