Can You Guess November's Mystery Condition?
Watch this video and make your diagnosis in the comments, and look for the answer in next month’s Blink.
Last Month’s Blink
Topotecan in the Anterior Chamber
Written by David H. Abramson, MD, and Jasmine H. Francis, MD. Photo by David H. Abramson, MD. Dr. Abramson and Dr. Francis are at Memorial Sloan Kettering Cancer Center and Weill-Cornell Medical School in New York, N.Y.
Topotecan is a topoisomerase inhibitor that is a semisynthetic derivative of camptothecin, a plant alkaloid. It is used in treating retinoblastoma and has been successfully administered through intravenous, intra-arterial, periocular, and intravitreal routes. It fluoresces in ultraviolet light.
This child had unilateral retinoblastoma with anterior chamber seeding after primary treatment, thus was treated with intracameral topotecan. The drug (20 μg/0.05 cc) was injected into the anterior chamber with a 33-gauge needle. In this image, the entry site is visible temporally, and the drug in the anterior chamber fluoresces, as do the aqueous veins of Ascher. There was no corneal toxicity once the drug cleared.
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