DR MRITTIKA SEN

DR. RAKSHA RAO, Dr. SANTOSH G. HONAVAR

Abstract

Purpose: To study efficacy of intravitreal topotecan (IVT) against vitreous seeds (VS) in retinoblastoma (RB). Methods: Retrospective, interventional study on 91 eyes of 90 patients with RB treated between 2013-2019. Patients with recurrent or refractory VS were treated with IVT (30µg/0.15ml) every 4 weeks till regression of VS. Results: Median age was 18m, group D(58, 64%), group E(26, 29%). VS were refractory in 46(51%) and recurrent in 45(49%) eyes. Median number of IVT injections were 2.5 for dust, 3 for sphere and 5 for cloud. Recurrence of VS was seen in 17(19%) eyes. At mean follow up 43m, VS regression was achieved in 88(97%) and eye salvage in 77(85%) eyes. Older age (p=0.018) and recurrence of retinal tumour (p<0.05) significantly increased the risk of VS recurrence. Cataract was the most common complication seen in 17(9%) eyes. Conclusion: IVT is effective against refractory and recurrent VS. Increasing age and recurrence of retinal tumor increase the risk of VS recurrence.

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