Successful Treatment of Macular Retinoblastoma With Superselective Ophthalmic Artery Infusion of Melphalan

Copyright © SLACK Incorporated INTRODUCTION Treatment options for retinoblastoma encompass: focal therapies (such as laser photocoagulation, thermotherapy, and cryotherapy), systemic (intravenous) chemotherapy, subconjunctival and intravitreal chemotherapy, intra-arterial superselective chemotherapy, brachytherapy with 125I or 106Ru plaques, external beam radiotherapy, and enucleation.1-4 Combining different treatments has resulted in significant improvement in survival rates, which have reached almost 99% in developed countries. However, the treatment of macular retinoblastoma still represents a challenge, particularly because of the trade-off between tumor-related and treatment-related visual loss. The central concern is the method of focal therapy, given the inherent risk of severe foveal damage and permanent visual loss. Avoiding laser applications or any other type of focal treatment directly to the fovea has been advocated to decrease the risk of severe treatment-related central visual loss.5 For the same purpose, other authors have investigated the benefits and risks of Purpose: To report our experience with superselective ophthalmic artery infusion of melphalan (SOAIM) for macular retinoblastoma to obtain tumor control while preserving as much useful vision as possible.