TABLE 3.
Side effects of intravitreal melphalan chemotherapy.
| Number of eyes | % | |
|---|---|---|
| Median follow up (total 27 eyes) | 42 months (range 6–72 months) | |
| Total number with eyes with side effects | 16 eyes | 59 |
| Tumor recurrence a | 6 eyes | 22 |
| Median time for recurrence | 6 months (range 3–12 months) | |
| Retinal toxicity b | 13 eyes | 48 |
| Pupillary synechia | 4 eyes | 15 |
| Iris atrophy | 2 eyes | 7 |
| Optic atrophy | 1 eye | 4 |
| Cataract (Dense) c | 8 (5) eyes | 30 (19) |
| Hypotonia and phthisis bulbi | 1 eye | 4 |
| Retinal hemorrhages | 1 eye | 4 |
| Endophthalmitis | None | 0 |
| Orbital tumor recurrence | 1 d | 4 |
| Distant metastasis | None | 0 |
Six eyes showed recurrent active tumor; three had massive recurrent vitreous seeds involving more than one quadrant (3, 4, and 6 months after the last injection), one eye had ciliary body and anterior chamber invasion, one eye had recurrent subretinal and vitreous seeds, and one eye had phthisis.
In total, 13 (48%) eyes developed retinal toxicity; seven eyes had Grade I toxicity, three eyes had Grade II toxicity, two eyes had Grade III toxicity, none had Grade IV toxicity, and one eye had Grade V toxicity (pan-retinopathy with optic atrophy)
Three of these eyes had radioactive plaque therapy.
One of the patients had a recurrent retinal tumor, subretinal seeds, and vitreous seeds associated with dense cataract, and the decision was for enucleation. The family refused this decision and decided not to treat. After getting lost in follow-up, they came back with orbital tumor recurrence.