Intra-Arterial Chemotherapy for Retinoblastoma

Purpose of Review To review the surgical technique, pharmacotherapy, contraindications, and outcomes of intra-arterial chemotherapy (IAC) in the treatment of retinoblastoma. Recent Findings IAC has emerged as a therapy for retinoblastoma. During IAC, a catheter is placed in the ophthalmic artery to selectively deliver chemotherapy. No universal protocol exists for the treatment of retinoblastoma, but melphalan, carboplatin, and topotecan triple-drug regimen are commonly used in IAC. The IAC doses are based on the patients’ age and weight and the severity and extent of the disease. Contraindications for IAC are poor visualization of the retinoblastoma tumor or extraocular extension. Summary IAC is a safe and effective treatment for retinoblastoma. Group B and C eyes have excellent outcomes of eye salvage. Eye salvage in groups D and E eyes is better with IAC than with systemic intravenous chemotherapy. However, randomized controlled trials are needed to further assess outcomes of IAC for retinoblastoma.