Skip to main content

Advertisement

SpringerLink
Log in

Intra-arterial and Intravitreal Chemotherapy for Retinoblastoma

  • Ocular Infections (B Jeng and L Schocket, Section Editors)
  • Published:
Current Ophthalmology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The aim of this review is to summarize history, treatment outcomes, indications, complications, and current controversies of both intra-arterial (IAC) and intravitreal (IViTC) chemotherapy in the management of retinoblastoma (RB).

Recent Findings

Over the years, the ability of IAC to provide excellent tumor control while limiting systemic toxicity has extended its indications from globe-sparing salvage therapy to the first-line therapy for unilateral disease. The establishment of safe IVitC techniques, on the other hand, has changed treatment philosophies from avoiding intraocular drug delivery at all costs to improve the control of vitreous seeds, which has been an important cause of failure of IAC. The use of both techniques has actually not only managed to reduce the enucleation rate but also to eliminate the need for external beam radiotherapy, at least as the first-line or second-line treatment.

Summary

During the past decade, IAC and IVitC have completely transformed the management of RB with a considerable improvement in ocular survival without affecting patient survival despite the lack of randomized controlled trials. Long-term prognosis, recurrence rates, and incidence of metastases after IAC and IVitC remain to be determined. Future challenges include studies of drug-induced retinal toxicity and optimization of treatment protocols in order to preserve vision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •Of importance ••Of major importance

  1. Shields CL, Lally SE, Leahey AM, et al. Targeted retinoblastoma management: when to use intravenous intra-arterial, periocular, and intravitreal chemotherapy. Curr Opin Ophthalmol. 2014;25:374–85.

    Article  PubMed  Google Scholar 

  2. Dimaras H, Corson TW, Cobrinik D, et al. Retinoblastoma. Nat Rev Dis Primers. 2015;1:15021.

    Article  PubMed  Google Scholar 

  3. Kaneko A, Takayama J, Matsuoka H, et al. Chemothermotherapy was successful in two cases of recurrence of intraocular retinoblastoma after irradiation. Japanese Journal of Clinical Ophthalmology. 1990;44(3):289–92.

    Google Scholar 

  4. Abramson DH, Dunkel IJ, Brodie SE, Kim JW, Gobin YP. A phase I/II study of direct intraarterial (ophthalmic artery) chemotherapy with melphalan for intraocular retinoblastoma initial results. Ophthalmology. 2008;115(8):1398–404. 1404 e1391

    Article  PubMed  Google Scholar 

  5. Wyse E, Handa JT, Friedman AD, Pearl MS. A review of the literature for intra-arterial chemotherapy used to treat retinoblastoma. Pediatr Radiol. 2016;46(9):1223–33.

    Article  PubMed  Google Scholar 

  6. •• Munier FL, Soliman S, Moulin AP, Gaillard MC, Balmer A, Beck-Popovic M. Profiling safety of intravitreal injections for retinoblastoma using an anti-reflux procedure and sterilisation of the needle track. Br J Ophthalmol. 2012;96(8):1084–7. This report describes the modern technique of intravitreal injection of chemotherapy

    Article  PubMed  Google Scholar 

  7. Ghassemi F, Shields CL. Intravitreal melphalan for refractory or recurrent vitreous seeding from retinoblastoma. Arch Ophthalmol. 2012;130(10):1268–71.

    Article  PubMed  Google Scholar 

  8. • Abramson DH, Shields CL, Munier FL, Chantada GL. Treatment of retinoblastoma in 2015: agreement and disagreement. JAMA Ophthalmol. 2015;133(11):1341–7. In this report, 4 authors of 4 different major retinoblastoma treatment centers (the two largest in North America—New York and Philadelphia, the largest clinic in Latin America (Buenos Aires) and one of the largest center in Europe (Lausanne) collectively summarize their experiences and current indications of IAC with an emphasis on areas of agreement and disagreement

    Article  PubMed  Google Scholar 

  9. Munier FL. Classification and management of seeds in retinoblastoma. Ellsworth Lecture Ghent August 24th 2013. Ophthalmic Genet. 2014;35(4):193–207.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Suzuki S, Yamane T, Mohri M, Kaneko A. Selective ophthalmic arterial injection therapy for intraocular retinoblastoma: the long-term prognosis. Ophthalmology. 2011;118(10):2081–7.

    Article  PubMed  Google Scholar 

  11. Abramson DH, Dunkel IJ, Brodie SE, Marr B, Gobin YP. Bilateral superselective ophthalmic artery chemotherapy for bilateral retinoblastoma: tandem therapy. Arch Ophthalmol. 2010;128(3):370–2.

    Article  PubMed  Google Scholar 

  12. Abramson DH, Marr BP, Francis JH, et al. Simultaneous bilateral ophthalmic artery chemosurgery for bilateral retinoblastoma (tandem therapy). PLoS One. 2016;11(6):e0156806.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shields CL, Bianciotto CG, Jabbour P, et al. Intra-arterial chemotherapy for retinoblastoma: report No. 1, control of retinal tumors, subretinal seeds, and vitreous seeds. Arch Ophthalmol. 2011;129(11):1399–406.

    Article  PubMed  Google Scholar 

  14. Shields CL, Bianciotto CG, Jabbour P, et al. Intra-arterial chemotherapy for retinoblastoma: report No. 2, treatment complications. Arch Ophthalmol. 2011;129(11):1407–15.

    Article  CAS  PubMed  Google Scholar 

  15. Abramson DH, Marr BP, Dunkel IJ, et al. Intra-arterial chemotherapy for retinoblastoma in eyes with vitreous and/or subretinal seeding: 2-year results. Br J Ophthalmol. 2012;96(4):499–502.

    Article  PubMed  Google Scholar 

  16. Gobin YP, Dunkel IJ, Marr BP, Brodie SE, Abramson DH. Intra-arterial chemotherapy for the management of retinoblastoma: four-year experience. Arch Ophthalmol. 2011;129(6):732–7.

    Article  PubMed  Google Scholar 

  17. •• Shields CL, Manjandavida FP, Lally SE, et al. Intra-arterial chemotherapy for retinoblastoma in 70 eyes: outcomes based on the international classification of retinoblastoma. Ophthalmology. 2014;121(7):1453–60. This report details 5 years experience of IAC for retinoblastoma as primary or secondary therapy, detailing globe salvage for respectively every ICRB group, seeding control, and treatment complications

    Article  PubMed  Google Scholar 

  18. Palioura S, Gobin YP, Brodie SE, Marr BP, Dunkel IJ, Abramson DH. Ophthalmic artery chemosurgery for the management of retinoblastoma in eyes with extensive (>50%) retinal detachment. Pediatr Blood Cancer. 2012;59(5):859–64.

    Article  PubMed  Google Scholar 

  19. Thampi S, Hetts SW, Cooke DL, et al. Superselective intra-arterial melphalan therapy for newly diagnosed and refractory retinoblastoma: results from a single institution. Clin Ophthalmol. 2013;7:981–9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bracco S, Leonini S, De Francesco S, et al. Intra-arterial chemotherapy with melphalan for intraocular retinoblastoma. Br J Ophthalmol. 2013;97(9):1219–21.

    Article  PubMed  Google Scholar 

  21. Akyuz C, Kiratli H, Sen H, Aydin B, Tarlan B, Varan A. Intra-arterial chemotherapy for retinoblastoma: a single-center experience. Ophthalmologica. 2015;234(4):227–32.

    Article  PubMed  Google Scholar 

  22. Ong SJ, Chao AN, Wong HF, Liou KL, Kao LY. Selective ophthalmic arterial injection of melphalan for intraocular retinoblastoma: a 4-year review. Jpn J Ophthalmol. 2015;59(2):109–17.

    Article  CAS  PubMed  Google Scholar 

  23. Abramson DH, Daniels AB, Marr BP, et al. Intra-arterial chemotherapy (ophthalmic artery chemosurgery) for group D retinoblastoma. PLoS One. 2016;11(1):e0146582.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Abramson DH, Marr BP, Brodie SE, Dunkel I, Palioura S, Gobin YP. Ophthalmic artery chemosurgery for less advanced intraocular retinoblastoma: five year review. PLoS One. 2012;7(4):e34120.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Yannuzzi NA, Francis JH, Marr BP, et al. Enucleation vs ophthalmic artery chemosurgery for advanced intraocular retinoblastoma: a retrospective analysis. JAMA Ophthalmol. 2015;133(9):1062–6.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Venturi C, Bracco S, Cerase A, et al. Superselective ophthalmic artery infusion of melphalan for intraocular retinoblastoma: preliminary results from 140 treatments. Acta Ophthalmol. 2013;91(4):335–42.

    Article  CAS  PubMed  Google Scholar 

  27. De Francesco S, Galluzzi P, Bracco S, Menicacci F, Motolese E, Hadjistilianou T. Alternated intra-arterial and intravitreal chemotherapy for advanced intraocular retinoblastoma: preliminary successful results without systemic chemotherapy. Int Ophthalmol. 2015;35(6):887–95.

    Article  PubMed  Google Scholar 

  28. Vajzovic LM, Murray TG, Aziz-Sultan MA, et al. Supraselective intra-arterial chemotherapy: evaluation of treatment-related complications in advanced retinoblastoma. Clin Ophthalmol. 2011;5:171–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Magan T, Khoo CT, Jabbour PM, Shields CL. Intraarterial chemotherapy for retinoblastoma in a 2-month-old infant. Retin Cases Brief Rep. 11:24–26 2017.

  30. Peterson EC, Elhammady MS, Quintero-Wolfe S, Murray TG, Aziz-Sultan MA. Selective ophthalmic artery infusion of chemotherapy for advanced intraocular retinoblastoma: initial experience with 17 tumors. J Neurosurg. 2011;114(6):1603–8.

    Article  PubMed  Google Scholar 

  31. Michaels ST, Abruzzo TA, Augsburger JJ, Correa ZM, Lane A, Geller JI. Selective ophthalmic artery infusion chemotherapy for advanced intraocular retinoblastoma: CCHMC early experience. J Pediatr Hematol Oncol. 2016;38(1):65–9.

    Article  CAS  PubMed  Google Scholar 

  32. Marr BP, Brodie SE, Dunkel IJ, Gobin YP, Abramson DH. Three-drug intra-arterial chemotherapy using simultaneous carboplatin, topotecan and melphalan for intraocular retinoblastoma: preliminary results. Br J Ophthalmol. 2012;96(10):1300–3.

    Article  PubMed  Google Scholar 

  33. • Francis JH, Abramson DH, Gobin YP, et al. Efficacy and toxicity of second-course ophthalmic artery chemosurgery for retinoblastoma. Ophthalmology. 2015;122(5):1016–22.Those two simultaneously published reports studied success rate of secondary (or rescue) IAC after initial IAC, causes of recurrence, and systemic toxicity of the treatment

  34. • Shields CL, Say EA, Pointdujour-Lim R, Cao C, Jabbour PM, Shields JA. Rescue intra-arterial chemotherapy following retinoblastoma recurrence after initial intra-arterial chemotherapy. J Fr Ophtalmol. 2015;38(6):542–9. Those two simultaneously published reports studied success rate of secondary (or rescue) IAC after initial IAC, causes of recurrence, and systemic toxicity of the treatment

    Article  CAS  PubMed  Google Scholar 

  35. Francis JH, Gobin YP, Brodie SE, Marr BP, Dunkel IJ, Abramson DH. Experience of intra-arterial chemosurgery with single agent carboplatin for retinoblastoma. Br J Ophthalmol. 2012;96(9):1270–1.

    Article  PubMed  Google Scholar 

  36. Shields CL, Kaliki S, Shah SU, et al. Minimal exposure (one or two cycles) of intra-arterial chemotherapy in the management of retinoblastoma. Ophthalmology. 2012;119(1):188–92.

    Article  PubMed  Google Scholar 

  37. Munier FL, Gaillard MC, Balmer A, Beck-Popovic M. Intravitreal chemotherapy for vitreous seeding in retinoblastoma: recent advances and perspectives. Saudi J Ophthalmol. 2013;27(3):147–50.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Gobin YP, Dunkel IJ, Marr BP, Francis JH, Brodie SE, Abramson DH. Combined, sequential intravenous and intra-arterial chemotherapy (bridge chemotherapy) for young infants with retinoblastoma. PLoS One. 2012;7(9):e44322.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Francis JH, Abramson DH, Gobin YP, et al. Electroretinogram monitoring of dose-dependent toxicity after ophthalmic artery chemosurgery in retinoblastoma eyes: six year review. PLoS One. 2014;9(1):e84247.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kaneko A, Suzuki S. Eye-preservation treatment of retinoblastoma with vitreous seeding. Jpn J Clin Oncol. 2003;33(12):601–7.

    Article  PubMed  Google Scholar 

  41. • Munier FL, Gaillard MC, Balmer A, et al. Intravitreal chemotherapy for vitreous disease in retinoblastoma revisited: from prohibition to conditional indications. Br J Ophthalmol. 2012;96(8):1078–83. This is the first report on clinically documented case series of patients with retinoblastoma treated with IViC, showing unprecedented success rate of tumor control in the presence of vitreous seeding

    Article  PubMed  Google Scholar 

  42. Lee JH, Han JW, Hahn SM, Lyu CJ, Kim DJ, Lee SC. Combined intravitreal melphalan and intravenous/intra-arterial chemotherapy for retinoblastoma with vitreous seeds. Graefes Arch Clin Exp Ophthalmol. 2016;254(2):391–4.

    Article  CAS  PubMed  Google Scholar 

  43. Smith SJ, Smith BD. Evaluating the risk of extraocular tumour spread following intravitreal injection therapy for retinoblastoma: a systematic review. Br J Ophthalmol. 2013;97(10):1231–6.

    Article  PubMed  Google Scholar 

  44. Ji X, Hua P, Li J, Li J, Zhao J, Zhao P. Intravitreal melphalan for vitreous seeds: initial experience in China. J Ophthalmol. 2016;2016:4387286.

    PubMed  PubMed Central  Google Scholar 

  45. Suzuki S, Aihara Y, Fujiwara M, Sano S, Kaneko A. Intravitreal injection of melphalan for intraocular retinoblastoma. Jpn J Ophthalmol. 2015;59(3):164–72.

    Article  CAS  PubMed  Google Scholar 

  46. Shields CL, Douglass AM, Beggache M, et al. Intravitreous chemotherapy for active vitreous seeding from retinoblastoma: outcomes after 192 consecutive injections. The 2015 Howard Naquin Lecture. Retina. 2016;36(6):1184–90.

    Article  CAS  PubMed  Google Scholar 

  47. Francis JH, Schaiquevich P, Buitrago E, et al. Local and systemic toxicity of intravitreal melphalan for vitreous seeding in retinoblastoma: a preclinical and clinical study. Ophthalmology. 2014;121(9):1810–7.

    Article  PubMed  Google Scholar 

  48. Smith SJ, Pulido JS, Salomao DR, Smith BD, Mohney B. Combined intravitreal and subconjunctival carboplatin for retinoblastoma with vitreous seeds. Br J Ophthalmol. 2012;96(8):1073–7.

    Article  PubMed  Google Scholar 

  49. Ghassemi F, Shields CL, Ghadimi H, Khodabandeh A, Roohipoor R. Combined intravitreal melphalan and topotecan for refractory or recurrent vitreous seeding from retinoblastoma. JAMA Ophthalmol. 2014;132(8):936–41.

    Article  PubMed  Google Scholar 

  50. Manjandavida FP, Shields CL. The role of intravitreal chemotherapy for retinoblastoma. Indian J Ophthalmol. 2015;63(2):141–5.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Shields CL, Kaliki S, Shah SU, Bianciotto CG, Jabbour P, Shields JA. Effect of intraarterial chemotherapy on retinoblastoma-induced retinal detachment. Retina. 2012;32(4):799–804.

    Article  PubMed  Google Scholar 

  52. Shields CL, Alset AE, Say EA, et al. Retinoblastoma control with primary intra-arterial chemotherapy: outcomes before and during the intravitreal chemotherapy era. J Pediatr Ophthalmol Strabismus. 2016;1-10

  53. Smith SJ, Smith BD, Mohney BG. Ocular side effects following intravitreal injection therapy for retinoblastoma: a systematic review. Br J Ophthalmol. 2014;98(3):292–7.

    Article  PubMed  Google Scholar 

  54. Francis JH, Abramson DH, Gaillard MC, Marr BP, Beck-Popovic M, Munier FL. The classification of vitreous seeds in retinoblastoma and response to intravitreal melphalan. Ophthalmology. 2015;122(6):1173–9.

    Article  PubMed  Google Scholar 

  55. Francis JH, Marr BP, Abramson DH. Classification of vitreous seeds in retinoblastoma: correlations with patient, tumor, and treatment characteristics. Ophthalmology. 2016;123(7):1601–5.

    Article  PubMed  Google Scholar 

  56. Yousef YA, Soliman SE, Astudillo PP, et al. Intra-arterial chemotherapy for retinoblastoma: a systematic review. JAMA Ophthalmol. 2016;134:5. doi:10.1001/jamaophthalmol.2016.0244.

  57. Jenkinson H. Retinoblastoma: diagnosis and management—the UK perspective. Arch Dis Child. 2015;100(11):1070–5.

    Article  PubMed  Google Scholar 

  58. Reese AB, Hyman GA, Tapley ND, Forrest AW. The treatment of retinoblastoma by x-ray and triethylene melamine. AMA Arch Ophthalmol. 1958;60(5):897–906.

    Article  CAS  PubMed  Google Scholar 

  59. Klufas MA, Gobin YP, Marr B, Brodie SE, Dunkel IJ, Abramson DH. Intra-arterial chemotherapy as a treatment for intraocular retinoblastoma: alternatives to direct ophthalmic artery catheterization. AJNR Am J Neuroradiol. 2012;33(8):1608–14.

    Article  CAS  PubMed  Google Scholar 

  60. Bracco S, Venturi C, Leonini S, et al. Transorbital anastomotic pathways between the external and internal carotid systems in children affected by intraocular retinoblastoma. Surg Radiol Anat. 2016;38(1):79–87.

    Article  PubMed  Google Scholar 

  61. Inomata M, Kaneko A. Chemosensitivity profiles of primary and cultured human retinoblastoma cells in a human tumor clonogenic assay. Jpn J Cancer Res. 1987;78(8):858–68.

    CAS  PubMed  Google Scholar 

  62. Dunkel IJ, Shi W, Salvaggio K, et al. Risk factors for severe neutropenia following intra-arterial chemotherapy for intra-ocular retinoblastoma. PLoS One. 2014;9(10):e108692.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Abramson DH, Schefler AC. Update on retinoblastoma. Retina. 2004;24(6):828–48.

    Article  PubMed  Google Scholar 

  64. Berry JL, Jubran R, Kim JW, et al. Long-term outcomes of Group D eyes in bilateral retinoblastoma patients treated with chemoreduction and low-dose IMRT salvage. Pediatr Blood Cancer. 2013;60(4):688–93.

    Article  PubMed  Google Scholar 

  65. Shields CL, Honavar SG, Meadows AT, et al. Chemoreduction plus focal therapy for retinoblastoma: factors predictive of need for treatment with external beam radiotherapy or enucleation. Am J Ophthalmol. 2002;133(5):657–64.

    Article  PubMed  Google Scholar 

  66. Schaiquevich P, Buitrago E, Taich P, et al. Pharmacokinetic analysis of melphalan after superselective ophthalmic artery infusion in preclinical models and retinoblastoma patients. Invest Ophthalmol Vis Sci. 2012;53(7):4205–12.

    Article  CAS  PubMed  Google Scholar 

  67. Abramson DH, Ellsworth RM, Rosenblatt M, Tretter P, Jereb B, Kitchin FD. Retreatment of retinoblastoma with external beam irradiation. Arch Ophthalmol. 1982;100(8):1257–60.

    Article  CAS  PubMed  Google Scholar 

  68. De la Huerta I, Seider MI, Hetts SW, Damato BE. Delayed cerebral infarction following intra-arterial chemotherapy for retinoblastoma. JAMA Ophthalmol. 2016;134(6):712–4.

    Article  PubMed  Google Scholar 

  69. Maidana DE, Pellegrini M, Shields JA, Shields CL. Choroidal thickness after intraarterial chemotherapy for retinoblastoma. Retina. 2014;34(10):2103–9.

    Article  CAS  PubMed  Google Scholar 

  70. Susskind D, Hagemann U, Schrader M, Januschowski K, Schnichels S, Aisenbrey S. Toxic effects of melphalan, topotecan and carboplatin on retinal pigment epithelial cells. Acta Ophthalmol. 2016;94(5):471–8.

    Article  PubMed  Google Scholar 

  71. Ericson LA, Rosengren BH. Present therapeutic resources in retinoblastoma. Acta Ophthalmol. 1961;39:569–76.

    Article  CAS  Google Scholar 

  72. Seregard S, Kock E, Af Trampe E. Intravitreal chemotherapy for recurrent retinoblastoma in an only eye. Br J Ophthalmol. 1995;79(2):194–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Kivela T, Eskelin S, Paloheimo M. Intravitreal methotrexate for retinoblastoma. Ophthalmology. 2011;118(8):1689. 1689 e1681-1686

    Article  PubMed  Google Scholar 

  74. Francis JH, Xu XL, Gobin YP, Marr BP, Brodie SE, Abramson DH. Death by water: precautionary water submersion for intravitreal injection of retinoblastoma eyes. Open Ophthalmol J. 2014;8:7–11.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Ueda M, Tanabe J, Inomata M, Kaneko A, Kimura T. Study on conservative treatment of retinoblastoma—effect of intravitreal injection of melphalan on the rabbit retina. Nippon Ganka Gakkai Zasshi. 1995;99(11):1230–5.

    CAS  PubMed  Google Scholar 

  76. Buitrago E, Hocht C, Chantada G, et al. Pharmacokinetic analysis of topotecan after intra-vitreal injection. Implications for retinoblastoma treatment. Exp Eye Res. 2010;91(1):9–14.

    Article  CAS  PubMed  Google Scholar 

  77. Schaiquevich P, Carcaboso AM, Buitrago E, et al. Ocular pharmacology of topotecan and its activity in retinoblastoma. Retina. 2014;34(9):1719–27.

    Article  CAS  PubMed  Google Scholar 

  78. Abramson DH, Beaverson KL, Chang ST, Dunkel IJ, McCormick B. Outcome following initial external beam radiotherapy in patients with Reese-Ellsworth group Vb retinoblastoma. Arch Ophthalmol. 2004;122(9):1316–23.

    Article  PubMed  Google Scholar 

  79. Shields CL, Mashayekhi A, Au AK, et al. The International Classification of Retinoblastoma predicts chemoreduction success. Ophthalmology. 2006;113(12):2276–80.

    Article  PubMed  Google Scholar 

  80. Francis JH, Marr BP, Brodie SE, Gobin P, Dunkel IJ, Abramson DH. Intravitreal melphalan as salvage therapy for refractory retinal and subretinal retinoblastoma. Retin Cases Brief Rep. 10:357–360 2016.

  81. Shimoda Y, Hamano R, Ishihara K, et al. Effects of intraocular irrigation with melphalan on rabbit retinas during vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2008;246(4):501–8.

    Article  CAS  PubMed  Google Scholar 

  82. Mathew AA, Sachdev N, Staffieri SE, McKenzie JD, Elder JE. Superselective intra-arterial chemotherapy for advanced retinoblastoma complicated by metastatic disease. J AAPOS. 2015;19(1):72–4.

    Article  PubMed  Google Scholar 

  83. Chantada GL, Fandino AC, Schvartzman E, Raslawski E, Schaiquevich P, Manzitti J. Impact of chemoreduction for conservative therapy for retinoblastoma in Argentina. Pediatr Blood Cancer. 2014;61(5):821–6.

    Article  PubMed  Google Scholar 

  84. Shields CL, Meadows AT, Shields JA, Carvalho C, Smith AF. Chemoreduction for retinoblastoma may prevent intracranial neuroblastic malignancy (trilateral retinoblastoma). Arch Ophthalmol. 2001;119(9):1269–72.

    Article  CAS  PubMed  Google Scholar 

  85. Ramasubramanian A, Kytasty C, Meadows AT, Shields JA, Leahey A, Shields CL. Incidence of pineal gland cyst and pineoblastoma in children with retinoblastoma during the chemoreduction era. Am J Ophthalmol. 2013;156(4):825–9.

    Article  PubMed  Google Scholar 

  86. Kim JW, Kathpalia V, Dunkel IJ, Wong RK, Riedel E, Abramson DH. Orbital recurrence of retinoblastoma following enucleation. Br J Ophthalmol. 2009;93(4):463–7.

    Article  CAS  PubMed  Google Scholar 

  87. Yannuzzi NA, Francis JH, Abramson DH. Incidence of orbital recurrence after enucleation or ophthalmic artery chemosurgery for advanced intraocular retinoblastoma—reply. JAMA Ophthalmol. 2016;134(1):114–5.

    Article  PubMed  Google Scholar 

  88. Delhiwala KS, Vadakkal IP, Mulay K, Khetan V, Wick MR. Retinoblastoma: an update. Semin Diagn Pathol. 2016;33(3):133–40.

    Article  PubMed  Google Scholar 

  89. Vijayakrishnan R, Shields CL, Ramasubramanian A, Emrich J, Rosenwasser R, Shields JA. Irradiation toxic effects during intra-arterial chemotherapy for retinoblastoma: should we be concerned? Arch Ophthalmol. 2010;128(11):1427–31.

    Article  PubMed  Google Scholar 

  90. Abramson DH, Fabius AW, Issa R, et al. Advanced unilateral retinoblastoma: the impact of ophthalmic artery chemosurgery on enucleation rate and patient survival at MSKCC. PLoS One. 2015;10(12):e0145436.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Pavlidou E, Burris C, Thaung C, et al. Anterior segment seeding in eyes with retinoblastoma failing to respond to intraophthalmic artery chemotherapy. JAMA Ophthalmol. 2015;133(12):1455–8.

    Article  PubMed  Google Scholar 

  92. Shields CL, Lally SE, Manjandavida FP, Leahey AM, Shields JA. Diffuse anterior retinoblastoma with globe salvage and visual preservation in 3 consecutive cases. Ophthalmology. 2016;123(2):378–84.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Support was provided by the Eye Tumor Research Foundation, Philadelphia, PA (CLS). The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, and in the preparation, review, or approval of the manuscript. Carol L. Shields, M.D., has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Author information

Authors and Affiliations

  1. Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street, 14th floor, Philadelphia, PA, 19107, USA

    Christina Stathopoulos, Emil Anthony T. Say & Carol L. Shields

Authors
  1. Christina Stathopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emil Anthony T. Say
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carol L. Shields
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carol L. Shields.

Ethics declarations

Conflict of Interest

Emil Anthony Say, Carol Shields, and Christina Stathopoulos declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Ocular Infections

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stathopoulos, C., Say, E.A.T. & Shields, C.L. Intra-arterial and Intravitreal Chemotherapy for Retinoblastoma. Curr Ophthalmol Rep 5, 73–84 (2017). https://doi.org/10.1007/s40135-017-0123-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40135-017-0123-6

Keywords

Search

Navigation