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| intravitreal_injection_retinoblastoma [2020/08/27 00:03] – [Drugs] Scott Larson | intravitreal_injection_retinoblastoma [2025/06/14 03:33] (current) – [Tools] Scott Larson | ||
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| ===== Drugs ===== | ===== Drugs ===== | ||
| - | * Melphalan | + | * Melphalan |
| + | * use 50 mg lypohilized powder for IV injection | ||
| * 0.25-0.3 mg per 0.5 ml | * 0.25-0.3 mg per 0.5 ml | ||
| * Deliver 25-30 ug in 0.05 ml | * Deliver 25-30 ug in 0.05 ml | ||
| * Reconstitue in 0.9% normal saline | * Reconstitue in 0.9% normal saline | ||
| - | | + | * Must be injected into the eye < 1 hour after being constituted |
| + | | ||
| * 20 μg in 0.04 ml (0.2 mg per 0.4 ml) | * 20 μg in 0.04 ml (0.2 mg per 0.4 ml) | ||
| * Reconstitue in 0.9% normal saline | * Reconstitue in 0.9% normal saline | ||
| ===== Tools ===== | ===== Tools ===== | ||
| - | * 1 ml syringe or smaller {{: | + | * 1 ml syringe or smaller |
| - | * 30-33 gauge needle | + | * 30-33 gauge needle |
| * EUA set up (lid speculum, indenter, indirect, condensing lenses, etc.) | * EUA set up (lid speculum, indenter, indirect, condensing lenses, etc.) | ||
| * Tonopen | * Tonopen | ||
| * Cryo machine | * Cryo machine | ||
| * Sterile Water | * Sterile Water | ||
| + | * 60 ml syringe | ||
| + | * kidney basin | ||
| ===== Steps ===== | ===== Steps ===== | ||
| + | - Call Pharmacy (x64300) 20 minutes before desired drug delivery time. | ||
| - Choose an injection site distant from any vitreous or retinal tumors | - Choose an injection site distant from any vitreous or retinal tumors | ||
| - Lower intraocular pressure to <10mmHg with digital massage | - Lower intraocular pressure to <10mmHg with digital massage | ||
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| - [[pars_plana_sclerotomy|Inject 2.5-3 mm from limbus]] directing the needle towards the center of the vitreous but avoid known vitreous seeds | - [[pars_plana_sclerotomy|Inject 2.5-3 mm from limbus]] directing the needle towards the center of the vitreous but avoid known vitreous seeds | ||
| - Before retracting the needle tip from the vitreous apply cryo to the injection site and the needle. | - Before retracting the needle tip from the vitreous apply cryo to the injection site and the needle. | ||
| - | - Retract the needle and bathe the fornix with sterile water for 3 minutes | + | - [[https:// |
| - Apply a drop of betadine | - Apply a drop of betadine | ||
| - Inspect vitreous and retina if desired | - Inspect vitreous and retina if desired | ||
| - | {{: | + | {{: |
| - | {{: | + | {{: |
| Source: The role of intravitreal chemotherapy for retinoblastoma. Manjandavida FP, Shields CL. Indian J Ophthalmology 2014; | Source: The role of intravitreal chemotherapy for retinoblastoma. Manjandavida FP, Shields CL. Indian J Ophthalmology 2014; | ||
| Line 42: | Line 47: | ||
| ===== References ===== | ===== References ===== | ||
| - | * {{ :intravitreal_chemotherapy_for_vitreous_disease_in_retinoblastoma_revisited-_from_prohibition_to_conditional_indications.pdf |Intravitreal chemotherapy for vitreous disease in retinoblastoma revisited: from prohibition to conditional indications. Munier et al. Br J Ophthalmology 2012; | + | * [[https://1drv.ms/ |
| - | * {{ :rb_intravitreal_treatment_efficacy_and_toxicity_2017.pdf |Efficacy and Toxicity of Intravitreous Chemotherapy for Retinoblastoma: | + | * [[https://1drv.ms/ |
| - | * {{ :intravitreal_chemotherapy_in_retinoblastoma-_expanded_use_beyond_intravitreal_seeds.pdf |Intravitreal chemotherapy in retinoblastoma: | + | * [[https://1drv.ms/ |
| - | * {{ :the_role_of_intravitreal_chemotherapy_for_retinoblastoma.pdf |The role of intravitreal chemotherapy for retinoblastoma. Manjandavida FP, Shields CL. Indian J Ophthalmology 2014; | + | * [[https://1drv.ms/ |
| + | * [[https:// | ||
| - | {{tag> | + | {{tag> |