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Review
. 2024 Jun;10(3):167-171.
doi: 10.1159/000535826. Epub 2024 Jan 29.

Ciliary Madarosis Secondary to Intra-Arterial Chemotherapy for Retinoblastoma Treatment

Anabella Watts-Santos  1 , David Arturo Ancona-Lezama  2   3 , Jose A Figueroa-Sanchez  3 , Daniela Mares-Custodio  3 , Verónica Garza-Rodríguez  1
Affiliations
Review

Ciliary Madarosis Secondary to Intra-Arterial Chemotherapy for Retinoblastoma Treatment

Anabella Watts-Santos et al. Skin Appendage Disord. 2024 Jun.

Abstract

Background: Retinoblastoma is the most common intraocular tumor in the pediatric population. Its main therapeutic objectives are to avoid fatal outcomes and preserve vision as much as possible. Intra-arterial chemotherapy (IAC) improves drug delivery and reduces possible systemic adverse effects. This modality allows direct administration of chemotherapeutic agents to intraocular malignancies via the ophthalmic artery (OA), proving to be a feasible and effective method for globe salvage. Most side effects of IAC are local, including eyelash loss of the nasal portion of the eyelid.

Summary: We performed a comprehensive review to analyze data regarding ciliary madarosis in patients diagnosed with retinoblastoma treated with IAC. We describe 9 studies with a total of 637 eyes with retinoblastoma that underwent IAC, of which 45 cases presented madarosis. In chemotherapy-induced alopecia, there is hair shaft thinning and breakage. On trichoscopy, the remaining end of the fractured hair will be observed as black dots. Differential diagnoses must include alopecia areata and trichotillomania.

Key messages: Ciliary madarosis secondary to IAC, although transitional, may cause discomfort in patients and family members. Physical examination, as well as a trichoscopic evaluation of the affected area, can help in reaching a prompt diagnosis and prognosis for this particular alopecia.

Keywords: Alopecia; Chemotherapy; Ciliary; Intra-arterial chemotherapy; Madarosis; Retinoblastoma.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Ciliary madarosis is observed on a 2-year-old girl’s left eye after IAC administration, with melphalan. She presented mild edema with inner and middle third eyelash loss in her left upper eyelid.
Fig. 2.
Fig. 2.
Trichoscopy of the upper left eyelid shows yellow and black dots as well as upright regrowing hairs.
See this image and copyright information in PMC

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