Vascularized vitreous seeding regression following systemic and intravitrealchemotherapy for advanced "late" retinoblastoma

Purpose To report the regression of vascularized vitreous seeding in advanced "late" retinoblastoma Methods Case report 8 year old girl with bilateral disease. The affected eye was the left eye (group D -ABC classification- and group VB -Reese Classification-) while the right eye presented two peripheral retinomas. Results Complete remission of the massive vascularized vitreous seeding was achieved and multiple retinal tumors regressed following six cycles of systemic chemotherapy (three drugs-carboplatin etoposide and vincristine) and four intravitreal injections with Melphalan (20 micrograms). Retinal tumors presented type I regression (calcified tumors) while massive vitreous seeding was replaced by spidernet fibrotic formations. Conclusion This case highlights the successful combination of three-drugs systemic chemotherapy with intravitreal melphalan in advanced "late" retinoblastoma presenting with vascularized vitreous seeding and multiple retinal tumors.