To the Editor We have read with great interest the Observation by Paez-Escamilla et al1 reporting a case of successful intracameral chemotherapy (ICC) for anterior chamber seeds (ACS) with a single dose of topotecan. We compliment the authors. However, we have several comments and questions.
First of all, could the authors comment on how intravitreal injection of melphalan could appropriately target ACS? Its pharmokinetics in the aqueous after this route of administration have been shown to predict less than 1% of the vitreous drug exposure.2
Munier FL, Gaillard M, Stathopoulos C. Anterior Chamber Chemotherapy in Retinoblastoma—Necessary but Not Sufficient for Aqueous Seeding Control. JAMA Ophthalmol. Published online March 29, 2018. doi:10.1001/jamaophthalmol.2018.0630
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