Fig. 4

Retinal vessel toxicity. The recurrence of a retinoblastoma with a sphere of vitreous seeds was treated with two injections of intravitreal melphalan (30 μg) (a). The patient tolerated the initial injection well, with no apparent intraoperative or immediate postoperative complications. At the 1-week follow-up, the visual acuity was decreased to light perception, and the patient showed evidence of diffuse vascular occlusion with retinal edema and hemorrhage (b). At the 6-month follow-up, the patient showed evidence of pupillary synechiae, iris atrophy, and iris neovascularization (c). The fundus was not visible. At the 8-month follow-up, B-scan indicated the suspicious recurrence of the tumor. The eye was enucleated. The pathological findings revealed the severe atrophy of retina, choroid (d) and optic nerve (e) as well as extensive reactive gliosis with tumor invasion of ciliary body and choroid (f). (H&E, × 50)