Periocular Chemotherapy for Retinoblastoma: Success With Problems?

Retinoblastoma frontiers with intravenous, intra-arterial, periocular, and intravitreal chemotherapy

“…[58][59][60][61] Initial reports suggested some success with subtenon's carboplatin as primary therapy. 62 Because of later recurrences, however, this therapy was used more often in conjunction with systemic chemotherapy to boost the local dose of chemotherapy in the vitreous.…”

Retinoblastoma frontiers with intravenous, intra-arterial, periocular, and intravitreal chemotherapy

“…[58][59][60][61] Initial reports suggested some success with subtenon's carboplatin as primary therapy. 62 Because of later recurrences, however, this therapy was used more often in conjunction with systemic chemotherapy to boost the local dose of chemotherapy in the vitreous.…”

Advancing the Treatments of Retinoblastoma: Stuck in the 1950s

“…We have moved rapidly from periocular to intra-arterial to intravitreal and now to intracameral administration with the specific aims of delivering an increasingly higher concentration of chemotherapy in hopes of controlling ocular disease, while mitigating systemic side effects [7][8][9] . These advances have been heralded as successes, but each in turn has been overshadowed by a battery of subsequent case reports and small case series detailing complications of the technique [10][11][12][13] . Many reports show late toxicity to the organ for which salvage was attempted, while reports of metastatic disease remind us that losing sight of the entire child can have dire consequences.…”

Ocular Pharmacology of Topotecan and Its Activity in Retinoblastoma

“…Periocular injection of chemotherapy is an option for delivering chemotherapy to the posterior segment of the eye, specifically for vitreous seeds. 40 An advantage of this route is that the drug theoretically follows a transscleral passage and, through the choroid and retina, may reach the target tissue circumventing the blood-retinal barrier. However, orbital clearance of the drugs after injection into the periocular space should be avoided.…”

Retinoblastoma frontiers with intravenous, intra-arterial, periocular, and intravitreal chemotherapy

“…[58][59][60][61] Initial reports suggested some success with subtenon's carboplatin as primary therapy. 62 Because of later recurrences, however, this therapy was used more often in conjunction with systemic chemotherapy to boost the local dose of chemotherapy in the vitreous.…”

Advancing the Treatments of Retinoblastoma: Stuck in the 1950s

“…We have moved rapidly from periocular to intra-arterial to intravitreal and now to intracameral administration with the specific aims of delivering an increasingly higher concentration of chemotherapy in hopes of controlling ocular disease, while mitigating systemic side effects [7][8][9] . These advances have been heralded as successes, but each in turn has been overshadowed by a battery of subsequent case reports and small case series detailing complications of the technique [10][11][12][13] . Many reports show late toxicity to the organ for which salvage was attempted, while reports of metastatic disease remind us that losing sight of the entire child can have dire consequences.…”

Ocular Pharmacology of Topotecan and Its Activity in Retinoblastoma

“…Periocular injection of chemotherapy is an option for delivering chemotherapy to the posterior segment of the eye, specifically for vitreous seeds. 40 An advantage of this route is that the drug theoretically follows a transscleral passage and, through the choroid and retina, may reach the target tissue circumventing the blood-retinal barrier. However, orbital clearance of the drugs after injection into the periocular space should be avoided.…”

Retinoblastoma frontiers with intravenous, intra-arterial, periocular, and intravitreal chemotherapy

“…[58][59][60][61] Initial reports suggested some success with subtenon's carboplatin as primary therapy. 62 Because of later recurrences, however, this therapy was used more often in conjunction with systemic chemotherapy to boost the local dose of chemotherapy in the vitreous.…”

Advancing the Treatments of Retinoblastoma: Stuck in the 1950s

“…We have moved rapidly from periocular to intra-arterial to intravitreal and now to intracameral administration with the specific aims of delivering an increasingly higher concentration of chemotherapy in hopes of controlling ocular disease, while mitigating systemic side effects [7][8][9] . These advances have been heralded as successes, but each in turn has been overshadowed by a battery of subsequent case reports and small case series detailing complications of the technique [10][11][12][13] . Many reports show late toxicity to the organ for which salvage was attempted, while reports of metastatic disease remind us that losing sight of the entire child can have dire consequences.…”

Ocular Pharmacology of Topotecan and Its Activity in Retinoblastoma

“…Periocular injection of chemotherapy is an option for delivering chemotherapy to the posterior segment of the eye, specifically for vitreous seeds. 40 An advantage of this route is that the drug theoretically follows a transscleral passage and, through the choroid and retina, may reach the target tissue circumventing the blood-retinal barrier. However, orbital clearance of the drugs after injection into the periocular space should be avoided.…”