An updated review of intra-arterial chemotherapy for retinoblastoma

Retinoblastoma (RB) is the most common pediatric ocular malignancy and causes high mortality if left untreated. An accurate diagnosis and prompt treatment are of utmost importance, leading to optimal clinical outcomes. RB treatment has evolved over the years with a paradigm shift from life-saving enucleation to globe- and vision-sparing strategies. Intra-arterial chemotherapy (IAC) has become an essential and effective pillar in the management of RB. It has gained popularity as it is a targeted chemotherapeutic agent infusion technique achieved via superselective ophthalmic artery (OA) catheterisation. This improves tumour treatment and reduces recurrence and systemic side effects. In addition, it is often performed as an outpatient procedure, reducing the need for prolonged hospital stays and improving the overall patient experience. In this review, we discuss the history of IAC as well as its technical evolution, outcomes, potential complications and limitations.