First case of type IV hypersensitivity to periocular topotecan

Topotecan is a topoisomerase 1 inhibitor derived from the Camptotheca acuminata plant and has been approved by the US Food and Drug Administration for ovarian, cervical, and small cell lung cancers.1 More recently, periocular injection of topotecan with fibrin sealant has been used to treat retinoblastoma as an alternative to carboplatin.2 Injection is performed in the subtenon space with a fibrin sealant to extend the duration of intraocular drug penetration in tissue, reducing the number of injections required and limiting systemic toxic effects.

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