Ji Xunda, Hua Peiyan, Li Jing, Li Jiakai, Zhao Junyang, Zhao Peiquan
Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China.
Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, 56 Nanlishi Road, Xicheng District, Beijing 100045, China.
J Ophthalmol. 2016;2016:4387286. doi: 10.1155/2016/4387286. Epub 2016 Feb 8.
Purpose. To evaluate the efficacy of intravitreal melphalan for vitreous seeds from retinoblastoma in Chinese patients. Methods. This is a retrospective review of 17 consecutive Chinese patients (19 eyes) with viable vitreous seeds from retinoblastoma. The patients received multiple intravitreal injections of 20 ug melphalan. Results. The International Classification of Retinoblastoma groups were B in 1 eye, C in 5 eyes, D in 11 eyes, and E in 2 eyes. On average, 6 injections (range: 1-15) were given to each eye at the interval of 2-4 weeks. Successful control of vitreous seeds was achieved in 16 of 19 eyes (84.21%). Globe retention was achieved in 73.68% (14/19) eyes. The patients were followed up for 27 months on average (median: 26; range: 17-42 months). There is a significant difference in response to intravitreal melphalan for cloud, spheres, and dust seeds with a median number of injections of 9, 6, and 3, respectively (P = 0.003). Complications related to intravitreal melphalan included vitreous hemorrhage, cataract, salt-and-pepper retinopathy, and pupil posterior synechia. There was no case of epibulbar extension or systemic metastasis within the period of follow-up. Conclusion. Intravitreal melphalan achieved a high local control rate for vitreous seeds without extraocular extension and with acceptable toxicity in Chinese retinoblastoma patients.
目的。评估玻璃体内注射美法仑对中国视网膜母细胞瘤患者玻璃体内种植灶的疗效。方法。对17例（19只眼）连续的患有视网膜母细胞瘤活性玻璃体内种植灶的中国患者进行回顾性研究。患者接受多次玻璃体内注射20μg美法仑。结果。视网膜母细胞瘤国际分类中，1只眼为B组，5只眼为C组，11只眼为D组，2只眼为E组。每只眼平均注射6次（范围：1 - 15次），注射间隔为2 - 4周。19只眼中16只（84.21%）成功控制了玻璃体内种植灶。73.68%（14/19）的眼实现了眼球保留。患者平均随访27个月（中位数：26个月；范围：17 - 42个月）。玻璃体内注射美法仑对云雾状、球形和尘状种植灶的反应有显著差异，注射次数中位数分别为9次、6次和3次（P = 0.003）。与玻璃体内注射美法仑相关的并发症包括玻璃体积血、白内障、椒盐样视网膜病变和瞳孔后粘连。随访期间未出现眼球表面扩展或全身转移病例。结论。玻璃体内注射美法仑对中国视网膜母细胞瘤患者的玻璃体内种植灶实现了较高的局部控制率，且无眼外扩展，毒性可接受。
