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Publications

Journal Article Ahead of print

PubMed: 42480648 DOI: 10.1016/j.oret.2026.07.007

Transient Optical Coherence Tomography Changes after High-Dose Intravitreal Topotecan for retinoblastoma: case series.

Ophthalmol Retina

Authors: Christina Stathopoulos, Francis L Munier

Affiliations

  • Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Switzerland.
  • Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Switzerland.

Abstract

PURPOSE

To report and describe transient spectral-domain OCT (SD-OCT) changes following high-dose intravitreal topotecan (HD-IvitTopo) in retinoblastoma patients.

DESIGN

Retrospective case series.

SUBJECTS

Three eyes of three children with retinoblastoma treated with HD-IvitTopo (100 μg/0.20 cc), administered either as monotherapy during first-line treatment for macular (Case 1) or optic nerve-threatening tumors (Case 2), or combined with intracameral topotecan for vitreous and aqueous humor relapse (Case 3).

METHODS

Clinical examination, fundus photography, and SD-OCT were performed before and after each intravitreal injection. Full-field electroretinography (ERG) was assessed in one case MAIN OUTCOME MEASURES: Structural retinal changes on SD-OCT, reversibility of retinal alterations and functional outcomes.

RESULTS

All cases received 1 to 2 HD-IvitTopo injections. Case 1 developed early signs of loss of the ellipsoid zone and diffuse microcystic macular edema after the first HD-IvitTopo, which worsened after the second, without ERG alterations. Case 2 developed isolated foveolar cystic edema after the second HD-IvitTopo. Case 3 developed transient papillary and diffuse microcystic macular edema after the first combined intravitreal and intracameral topotecan injection. In all cases, all structural changes resolved completely within 10-16 weeks, with no permanent visual loss at date last seen.

CONCLUSIONS

High-dose IvitTopo (100 μg/0.20 cc) may induce transient, subclinical intraocular alterations detectable by SD-OCT. Further studies are warranted to elucidate the exact cause, incidence and functional impact of such events.

MeSH

Injections, Retinoblastoma, Ophthalmology, Tomography, Macular Edema, Tomography, Optical Coherence, Topotecan, Retinaldehyde, Edema