Intra-ophthalmic Artery Chemotherapy for Retinoblastoma

Super-selective intra-ophthalmic artery chemotherapy (SSIOAC) is an evolution of techniques designed to deliver high doses of chemotherapy to the eye to treat retinoblastoma. Initial publications appeared in 2008 detailing success of a phase I/II clinical trial using a myriad of chemotherapeutic agents but principally melphalan. Since that time, the technique has been readily adopted, and reports of its success have followed. However, with the successes have come, reports of local and systemic toxicities have been detailed in both isolated case reports and more encompassing meta-analyses. Included in these studies are development of metastatic disease and deaths due to prolonged efforts to save advanced non-seeing eyes. Additionally, preclinical modeling has detailed associated vascular complications. A recent multicenter Children’s Oncology Group Trial was closed early; results from the trial are pending