10.6084/m9.figshare.4499123.v1 Munier F.L. Munier F.L. Gaillard M.-C. Gaillard M.-C. Decembrini S. Decembrini S. Bongiovanni M. Bongiovanni M. Beck-Popovic M. Beck-Popovic M. Supplementary Material for: Intracameral Chemotherapy (Melphalan) for Aqueous Seeding in Retinoblastoma: Bicameral Injection Technique and Related Toxicity in a Pilot Case Study Karger Publishers 2016 Anterior chamber fluid Chemotherapy Intravitreal injection Pathology of the anterior segment Retinoblastoma Aqueous seeding Intracameral chemotherapy Melphalan 2016-12-28 13:19:30 Media https://karger.figshare.com/articles/media/Supplementary_Material_for_Intracameral_Chemotherapy_Melphalan_for_Aqueous_Seeding_in_Retinoblastoma_Bicameral_Injection_Technique_and_Related_Toxicity_in_a_Pilot_Case_Study/4499123 <p><b><i>Background:</i></b> The anterior chamber has been shown by pharmacokinetic studies to represent a sanctuary never achieving a tumoricidal dose with the present administration routes, such as systemic, intra-arterial, or intravitreal injections. <b><i>Method:</i></b> A novel intracameral chemotherapy technique is described to control aqueous seeding in a pilot unilateral group E retinoblastoma case with primary aqueous seeding. Anterior segment toxicity was carefully monitored. <b><i>Results:</i></b> Control of the retinal tumor and vitreous seeding was achieved by intra-arterial and intravitreal chemotherapies. Sterilization of the aqueous was achieved after a first cycle of 7 melphalan injections in the anterior chamber, but relapse was noted 3.5 months later. This relapse was finally controlled with a second cycle of 6 intracameral injections targeting the posterior chamber. Corneal endothelial cell density remained stable over the injection period. Heterochromia and a progressive cataract developed, which required cataract surgery. At 5 years' follow-up, the patient is tumor free with normal vision (20/20 in both eyes), full binocularity, and no metastasis. <b><i>Conclusions:</i></b> The present bicameral injection technique appears to be safe and effective with limited toxicity. Melphalan-induced side effects were noted on the iris and lens but with no impact on the final visual function.</p>