1. Date of download: 6/3/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Periocular Topotecan for Intraocular Retinoblastoma Arch Ophthalmol. 2011;129(6):738-745. doi:10.1001/archophthalmol.2011.130 Topotecan hydrochloride in fibrin mixing and injection procedure. Schematic diagram of the dilution of topotecan with Tisseel (Baxter, Deerfield, Illinois; the Duploject injection system is also manufactured by Baxter) and injection into the subtenon space. IV indicates intravenous. Figure Legend:

2. Date of download: 6/3/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Periocular Topotecan for Intraocular Retinoblastoma Arch Ophthalmol. 2011;129(6):738-745. doi:10.1001/archophthalmol.2011.130 Demonstration of periocular injection of topotecan hydrochloride in fibrin sealant. Periocular injection is given with Tisseel (Baxter, Deerfield, Illinois) through a 22-gauge intravenous cannula using the Duploject injection system (Baxter). Figure Legend:

3. Date of download: 6/3/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Periocular Topotecan for Intraocular Retinoblastoma Arch Ophthalmol. 2011;129(6):738-745. doi:10.1001/archophthalmol.2011.130 Tumor response to periocular topotecan hydrochloride in fibrin sealant. A, Patients 1 through 4 with 1 eye treated with periocular topotecan. The disease-specific timeline shows patient treatment history, with blue lines linking the event (see key) to the retinal image. Blue letters signify that the image was taken on the date of the first topotecan injection. Patient 1: (a) 21 days before the first topotecan injection, tumor recurrence treated with focal laser, (b) on the day of the first topotecan injection, nonresponsive to laser, (c) response 2 weeks after first injection, and (d) stabilized after 4 injections and laser consolidation. Patient 2: (a) on the day of the first topotecan injection, (b) response 1 month after first injection, and (c) stabilized after 4 injections and laser consolidation. Patient 3: (a) on the day of the first topotecan injection, (b) after 4 injections, 2.5 months after the first topotecan injection, and (c) 10 months after last injection. Patient 4: (a) at diagnosis, (b) on the day of the first topotecan injection, nonresponsive to laser, and (c) stabilized after 2 injections and laser consolidation. B, Patients 5 and 6 with both eyes treated by periocular topotecan. The disease- specific timeline shows patient treatment history, with blue lines linking the event (see key) to the retinal image. Blue letters signify that the image was taken on the date of the first topotecan injection. Patient 5 right eye (OD): (a) on the day of the first right eye topotecan injection, (b) after 2 injections, showing no response, and (c) on the last visit, stabilized, with laser consolidation. Patient 5 left eye (OS): (a) at diagnosis, (b) after 1 left eye injection, showing no response, and (c) on the last visit, stabilized, with laser consolidation. Patient 6 right eye: (a) on the day of the first right eye topotecan injection, (b) after 1 injection, showing no response, and (c) stabilized with laser consolidation. Patient 6 left eye: Tumor (a) on the day of the first left eye topotecan injection, (b) after 1 injection, showing no response, and (c) stabilized with laser consolidation. EUA indicates examination under anesthesia. Figure Legend: