Cataract formation: a possible complication of intra-arterial chemotherapy for retinoblastoma.

Abstract:

PURPOSE:To delineate and discuss a not yet described possible ocular complication of selective intra-arterial chemotherapy (SIAC) for treatment of retinoblastoma. METHODS:A 23-month-old girl with a large unilateral retinoblastoma was treated with repeated SIAC using 5 mg melphalan between July 2010 and January 2012. Clinical course of tumor and further ocular changes after therapy and histopathologic findings are described. RESULTS:In total, 5 SIAC were performed over a time period of 18 months. After the last SIAC, diffuse dense cataract prevented further funduscopy. In addition, anterior chamber seeding was obvious, leading to the decision to enucleate the eye. Histopathologically, nearly complete regression of the main tumor mass with prominent calcifications, but vital tumor seeding in the vitreous, on the lens surface, on the ciliary body, and in the anterior chamber, was observed. Peculiar vacuolation of the lens epithelial cells, liquefaction of the subepithelial lens fibers, and diffuse small vacuoles within the lens were striking. CONCLUSIONS:Repeated SIAC with melphalan may induce cataract formation, possibly as a toxic effect of the chemotherapeutic to the lens, maybe combined with radiation exposure during fluoroscopy. This ocular complication should be taken into consideration as a limitation of the number of feasible repeated treatments.

journal_name

Eur J Ophthalmol

authors

Suesskind D,Schrader M,Foerster MH,Ernemann U,Aisenbrey S

doi

10.5301/ejo.5000393

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

449-53

issue

3

eissn

1120-6721

issn

1724-6016

pii

F2EE21F9-30A0-4BCC-99D0-79C0D995C982

journal_volume

24

pub_type

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