melphalan and Papilledema

We report the case of a 15-month-old boy with retinoblastoma who developed exotropia secondary to a right medial rectus infarct after intra-arterial chemotherapy. He had unilateral sporadic group C tumor (International Classification of Retinoblastoma) and was treated with intra-arterial melphalan. One week after the first session of intra-ophthalmic arterial melphalan chemotherapy, he was noted to have orbital congestion, exotropia, and right adduction limitation. Magnetic resonance imaging was suggestive of a right medial rectus infarct. The tumor showed a good response to intra-arterial chemotherapy but the exotropia persisted.

Topics: Antineoplastic Agents, Alkylating; Edema; Exotropia; Fluorescein Angiography; Humans; Infant; Infarction; Infusions, Intra-Arterial; Ischemia; Magnetic Resonance Imaging; Male; Melphalan; Muscular Diseases; Oculomotor Muscles; Ophthalmic Artery; Papilledema; Radiography; Retinal Neoplasms; Retinoblastoma

We present the case of a 54-year-old woman with papilledema associated to POEMS syndrome. The presence of intracranial hypertension was detected and treatment started with acetazolamide.. The most common ophthalmological pathology in POEMS syndrome is papilledema, the etiology of which could be infiltrative, intracranial hypertension, inflammation or an increase of the vascular permeability. The correct diagnosis and treatment of papilledema, depending on its etiology, should permit an acceptable visual outcome to be achieved.

Topics: Acetazolamide; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Drug Therapy, Combination; Female; Humans; Intracranial Hypertension; Melphalan; Middle Aged; Papilledema; POEMS Syndrome; Prednisone; Rituximab; Visual Fields