Intra-Arterial Chemotherapy for Advanced Intraocular Retinoblastoma…

PURPOSE: To evaluate the safety and efficacy of intra-arterial chemotherapy as a treatment for advanced intraocular retinoblastoma and to present our single-center experience. MATERIALS AND METHODS: This single-center retrospective cohort study included 13 pediatric patients (15 eyes) who underwent intra-arterial chemotherapy between January 2020 and December 2024. Patients were categorized into two groups: those receiving treatment as a first-line option (group 1) and those treated following the failure of previous therapies (group 2). Data were collected on technical success, complications, ocular preservation, and visual function. Each patient was monitored for a minimum of 12 months after treatment initiation. RESULTS: According to the ICRB classification, most eyes (66.7%) were Groups D, followed by groups C and E. The mean age at presentation was 22.5 months. A total of 45 intra-arterial chemotherapy procedures were performed, with successful catheterization achieved in 97.8% of cases. Minor procedural complications were observed in 8.8% of sessions, with no serious systemic adverse events. Visual acuity was maintained or improved in 93.3% of treated eyes. No patients required enucleation, and no cases of metastasis or death occurred during follow-up. CONCLUSION: Intra-arterial chemotherapy is a technically feasible and promising globe-sparing treatment for intraocular retinoblastoma, demonstrating high technical success and a favorable safety profile in our cohort. While preliminary outcomes show preserved visual function and high ocular survival, larger studies with longer follow-up are necessary to confirm long-term efficacy and safety within a multidisciplinary framework.