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First page of Intraocular pressure changes following intravitreal Topotecan 90mcg/0.18cc for the treatment of retinoblastoma

Purpose:  To investigate the impact of injecting Topotecan 90mcg/0.18cc on intraocular pressure (IOP) in children with retinoblastoma Methods:  This was a prospective study of 78 eye encounters of 37 patients with retinoblastoma (22 males, 15 females, mean age: 3.5±2.2 years, range 0.50 to 7.96 years) injected with intravitreal 90 mcg Topotecan with 0.18ml volume. IOP was measured with a Schiotz tonometer at baseline prior to injecting, after digital massage, and then at specified time intervals following intravitreal injection of Topotecan 90mcg in 0.18ml volume. Mean arterial pressure (MAP) was either calculated from anesthesia records or recorded during anesthesia. When MAP was calculated from anesthesia records or recorded during anesthesia, the lower of the two were used. Results: Mean pre-injection IOP was 7.6±2.5 mm Hg (range: 2 to 20 mm Hg). Mean IOP 60 seconds after intravitreal topotecan was 37.3±17.4 mm Hg (range: 20 to 82 mm Hg). The IOP of 93.6% of patients was less than the MAP at all observed time points after injection. In patient eye encounters where IOP exceeded MAP, IOP resolved to below MAP in 4 minutes in all encounters. Additionally, in 4 minutes, 91% of patient eye encounters had IOP of below 29 mm Hg. Conclusion: Injection of intravitreal topotecan 90 mcg/0.18cc chemotherapy caused a transient rise in IOP. The mean IOP after 1 minute was 37.3±17.4 mm Hg and 91% of patient eye encounters had IOP below 29mm Hg in 4 minutes. In 93.6% of patient eye encounters, IOP was below MAP. IOP resolved to below MAP for all encounters within 4 minutes.

Journal Section:
Clinical Research
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S. Karger AG, Basel
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2025
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