Hemodynamic and Anatomic Variations Require an Adaptable Approach during Intra-Arterial Chemotherapy for Intraocular...

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Interventional Radiology

Background:

• Intra-arterial chemotherapy (IAC) is a key treatment for intraocular retinoblastoma.
• Catheterization of the ophthalmic artery can be challenging, necessitating alternative approaches.
• Adaptable IAC strategies are crucial for successful retinoblastoma management.

Purpose of the Study:

• To evaluate the effectiveness and safety of alternative IAC strategies for retinoblastoma.
• To describe methods used when the ophthalmic artery is difficult to catheterize or not visible.
• To compare outcomes of different IAC drug delivery patterns.

Main Methods:

• Retrospective study of 108 eyes with intraocular retinoblastoma undergoing IAC.
• Categorization of IAC into three patterns: fixed ophthalmic artery, fixed external carotid artery branches, and variable routes.
• Analysis of clinical outcomes (remission vs. enucleation) and adverse events.

Main Results:

• 448 IAC sessions performed; 83.70% via ophthalmic artery, 16.29% via external carotid artery branches.
• 24.52% of eyes required at least one procedure via external carotid artery branches.
• No significant difference in remission rates or enucleation between different IAC patterns; adverse events not correlated with any pattern.

Conclusions:

• Alternative IAC routes are effective and safe for intraocular retinoblastoma.
• These strategies provide comparable short-term outcomes to traditional ophthalmic artery infusion.
• Adaptable IAC approaches ensure treatment delivery even with challenging anatomy.