Furthermore, vitreous seeding
was observed in 14 eyes while sub-retinal seeding was observed in only 6.
There was presence of vitreous seeding
on examination in seven cases.
Because the vitreous is an avascular tissue and the systemic or intra-arterial administration of chemotherapy has limited transition to the vitreous, vitreous seeding is an especially important problem.
Intravitreal melphalan for refractory or recurrent vitreous seeding from retinoblastoma.
We report a case with whitish, elevated, vascularized retinal mass and vitreous seeding diagnosed as undifferentiated retinoblastoma.
As malignant retinal tumor with vitreous seeding of the left eye was diagnosed, the patient was informed sufficiently and decided to receive enucleation.
A suitable option to avoid enucleation after IAC failure would be the use of intravitreal melphalan, with or without topotecan, for extensive vitreous seeding
. This technique has been reported to achieve up to 100% control of vitreous seeding
[9, 10, 22].
A small raised mass usually can be seen on the retina, with possible vitreous seeding
. Retinoblastoma is often multifocal and requires examination of the entire retina.
Her right eye was blind and there was vitreous seeding
in the left eye (group Vb), where some useful vision remained.
This growth pattern is typically associated with vitreous seeding
, wherein small fragments of tissue become separated from the main tumour.
 reported on the efficacy of intravitreal melphalan for advanced retinoblastoma with vitreous seeding
. Twenty-three patients received a total of 122 intravitreal injections of melphalan (dose: 20-30 mcg) using a specialized technique and strict patient selection criteria.
High-risk features evaluated included the presence and extent of optic nerve (ON) invasion with respect to lamina cribrosa, the status of the ON cut margin, the presence of vitreous seedings
, and invasion of the sclera, anterior chamber, and choroid.