To study the long-term efficacy of intravitreal topotecan (IVT) for vitreous seeds in eyes with retinoblastoma and risk factors for their recurrence. Retrospective, non-comparative, interventional study. Ninety-one eyes of 90 patients with retinoblastoma treated between January 2013 and April 2019. Patients with recurrent or refractory vitreous seeds after completion of intravenous or intra-arterial chemotherapy were treated with IVT (30 μg/0.15 ml) by the safety-enhanced technique. The injection was repeated every 4 weeks until the regression of seeds. Patients with a minimum follow-up of 12 months were included in the analysis. Primary outcome measures were vitreous seed regression and eye salvage. Secondary outcomes were risk factors for vitreous seed recurrence after treatment with IVT, vision salvage, and complications of IVT. The median age of the patients was 18 months, with most having group D (n = 58 [64%]) and group E (n = 26 [29%]) retinoblastoma. Vitreous seeds were refractory in 46 eyes (51%) and recurrent in 45 eyes (49%). A total of 317 IVT injections were administered, with the median being 3 injections. The median number of IVT injections required was 2.5 injections for dust, 3 injections for sphere, and 5 injections for cloud morphologic features. Recurrence of vitreous seeds after IVT was seen in 17 eyes (19%) at a mean follow-up of 7.9 months. At a mean follow-up 34 months, vitreous seed regression was achieved in 88 eyes (97%) and eye salvage was achieved in 77 eyes (85%). Older age ( = 0.018) and recurrence of retinal tumor (15/17 eyes; < 0.01) significantly increased the risk of vitreous seed recurrence. Cataract was the most common complication seen in 17 eyes (9%). Intravitreal topotecan at an every 3- to 4-week regimen is effective against both refractory and recurrent vitreous seeds. The vitreous seed morphologic features correspond to the number of injections required for regression. Increasing age and recurrence of retinal tumor increase the risk of vitreous seed recurrence after treatment with IVT. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

中文翻译：

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玻璃体内拓扑替康治疗视网膜母细胞瘤玻璃体种子：91 只眼睛的长期回顾


研究玻璃体内拓扑替康（IVT）治疗视网膜母细胞瘤眼玻璃体种子的长​​期疗效及其复发的危险因素。回顾性、非比较性、干预性研究。 2013年1月至2019年4月期间治疗的90例视网膜母细胞瘤患者的91只眼。完成静脉或动脉化疗后出现复发或难治性玻璃体颗粒的患者采用安全增强技术进行IVT（30 μg/0.15 ml）治疗。每 4 周重复注射一次，直至种子消退。至少随访 12 个月的患者被纳入分析。主要结果指标是玻璃体种子退化和眼睛挽救。次要结局是 IVT 治疗后玻璃体颗粒复发的危险因素、视力挽救和 IVT 并发症。患者的中位年龄为 18 个月，大多数患有 D 组（n = 58 [64%]）和 E 组（n = 26 [29%]）视网膜母细胞瘤。 46 只眼 (51%) 的玻璃体种子难治，45 只眼 (49%) 的玻璃体种子复发。总共进行了 317 次 IVT 注射，中位数为 3 次。所需的 IVT 注射次数中位数为：灰尘注射 2.5 次、球体注射 3 次、云形态特征注射 5 次。在平均随访 7.9 个月时，17 只眼睛 (19%) 观察到 IVT 后玻璃体种子复发。平均随访 34 个月，88 只眼 (97%) 实现玻璃体种子消退，77 只眼 (85%) 实现眼部挽救。年龄较大（= 0.018）和视网膜肿瘤复发（15/17 眼；< 0.01）显着增加玻璃体颗粒复发的风险。白内障是 17 只眼睛 (9%) 中最常见的并发症。 每 3 至 4 周一次的玻璃体内注射托泊替康治疗方案对难治性和复发性玻璃体种子均有效。玻璃体种子形态特征对应于回归所需的注射次数。年龄增长和视网膜肿瘤复发会增加 IVT 治疗后玻璃体颗粒复发的风险。作者对本文讨论的任何材料没有专有或商业利益。