Nguyen Minh, Saunders Jessica, Pacheco M Cristina, Stacey Andrew W
Department of Ophthalmology, University of Washington, Seattle, Washington, USA.
Department of Pathology, University of Washington, Seattle, Washington, USA.
Ocul Oncol Pathol. 2021 Mar;7(1):44-47. doi: 10.1159/000509809. Epub 2020 Sep 25.
We report a case of retinal atrophy and progressive preretinal fibrosis in an eye previously treated with intravenous and intra-arterial chemotherapy (IAC), which evolved immediately after treatment with intravitreal injection of melphalan. The atrophy and fibrosis progressed later to proliferative retinopathy with dystrophic ossification. The patient was originally diagnosed with bilateral retinoblastoma at 4 months of age and was treated with systemic chemotherapy followed by IAC. New vitreous seeds developed and required treatment with intravitreal chemotherapy. There was resolution of vitreous seeding after 2 doses of intravitreal melphalan, but clinically the eye developed new, widespread retinal atrophy and fibrosis within 1 month of the second injection. This was followed by phthisis and late proliferative retinopathy nearly 1 year later. Retinoblastoma specialists should be aware of this potential complication of combined chemotherapy treatments.
我们报告了一例视网膜萎缩和进行性视网膜前纤维化的病例，该眼先前接受了静脉和动脉内化疗（IAC），在玻璃体内注射美法仑治疗后立即出现病变进展。萎缩和纤维化随后发展为伴有营养不良性骨化的增殖性视网膜病变。该患者最初在4个月大时被诊断为双侧视网膜母细胞瘤，接受了全身化疗，随后进行了IAC治疗。新的玻璃体种植体出现，需要进行玻璃体内化疗。在注射2剂玻璃体内美法仑后，玻璃体种植体消失，但在第二次注射后1个月内，患眼临床上出现了新的、广泛的视网膜萎缩和纤维化。随后在近1年后出现眼球痨和晚期增殖性视网膜病变。视网膜母细胞瘤专家应意识到联合化疗治疗的这种潜在并发症。
