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Published on: September 13, 2016
Effects of intraocular irrigation with melphalan on rabbit retinas during vitrectomy
Yukitoshi Shimoda1, Rika Hamano, Katuhiko Ishihara
1Department of Ophthalmology, Gunma University School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan. y-simo@pg7.so-net.ne.jp
Purpose:
To investigate the toxic effects of perfusion of intravitreal melphalan during vitrectomy on the rabbit retina.
Methods:
We performed electoretinography (ERG) in 18 eyes of 18 healthy albino rabbits before and after intraocular melphalan perfusion at concentrations of 5-, 10-, and 20-microg/ml during pars plana vitrectomy. Fellow eyes that underwent vitrectomy without melphalan served as controls. The histopathologic retinal changes were observed in both eyes of two rabbits from each group.
Results:
In the 5-microg/ml perfusion group, the ERGs and histology showed no substantial changes compared with control fellow eyes during 28 days postoperatively. In the 10- and 20-microg/ml groups, the mean a-wave amplitude decreased to 52% and 31% respectively of the fellow eye; the mean b-wave amplitude decreased to 52% and 19% respectively. However, the peak implicit time of the a- and b-waves did not significantly differ in the 10- and 20-microg/ml groups during 28 days postoperatively. Histologic sections showed necrosis of the inner nuclear layer and thinning of the outer nuclear layer in the 10-microg/ml group. Loss of the outer nuclear layer and the photoreceptor layer and necrosis of the inner nuclear layer were observed in the 20-microg/ml group.
Conclusion:
The intravitreal 5-microg/ml melphalan perfusion during vitrectomy appears to be nontoxic to the retina. This therapeutic modality might be a potential treatment for retinoblastoma with vitreous seeding.
Insights
Intravitreal melphalan perfusion at 5 µg/ml during vitrectomy is safe for rabbit retinas. Higher concentrations caused retinal toxicity, suggesting potential use for retinoblastoma with vitreous seeding.
Area of Science:
- Ophthalmology
- Retinal Toxicology
- Cancer Therapy
Background:
- Vitreous seeding in retinoblastoma poses treatment challenges.
- Melphalan is a chemotherapeutic agent used in cancer treatment.
- Intravitreal chemotherapy requires careful assessment of ocular toxicity.
Purpose of the Study:
- To evaluate the toxic effects of intravitreal melphalan perfusion during vitrectomy on rabbit retinas.
- To determine a safe concentration of melphalan for intravitreal use.
Main Methods:
- Electoretinography (ERG) and histopathology were used to assess retinal function and structure.
- Albino rabbits underwent pars plana vitrectomy with intravitreal melphalan perfusion at 5, 10, and 20 µg/ml.
- Control eyes underwent vitrectomy without melphalan.
Main Results:
- The 5 µg/ml melphalan group showed no significant retinal changes compared to controls.
- Higher concentrations (10 and 20 µg/ml) led to decreased ERG amplitudes (a- and b-waves).
- Histopathology revealed inner nuclear layer necrosis and outer nuclear layer thinning/loss at higher melphalan concentrations.
Conclusions:
- Intravitreal melphalan perfusion at 5 µg/ml during vitrectomy is non-toxic to the rabbit retina.
- This concentration may be a viable option for treating retinoblastoma with vitreous seeding.
- Further research is warranted to explore its therapeutic potential.
