Occurrence of Sectoral Choroidal Occlusive Vasculopathy and Retinal Arteriolar Embolization After Superselective Ophthalmic Artery Chemotherapy for Advanced Intraocular Retinoblastoma

Abstract

Superselective ophthalmic artery chemotherapy was effective in all patients with no stroke or other systemic vascular complications. Unlike intravenous chemoreduction, SOAC is associated with potentially sight-threatening adverse effects, such as severe chorioretinal atrophy secondary to subacute choroidal occlusive vasculopathy or central retinal artery embolism, not to mention the risk of ophthalmic artery obstruction, which was not observed in this series. Further analysis of the risks and benefits of SOAC will define its role within the therapeutic arsenal. Meanwhile, we suggest that SOAC should be given in one eye only and restricted to advanced cases of retinoblastoma, as an alternative to enucleation and/or external beam radiotherapy.

Conservative treatment of retinoblastoma: a prospective phase II randomized trial of neoadjuvant chemotherapy followed by local treatments and chemothermotherapy

“…30,31 Short-term ocular toxicity may be seen with ischemic short-term complications being described. 32,33 However, more follow-up is needed to evaluate long-term ocular preservation and toxicity of the technique. Intravitreal injection of chemotherapy may be an interesting tool in the management of selected cases with active vitreous seeding.…”

Hemodynamic and Anatomic Variations Require an Adaptable Approach during Intra-Arterial Chemotherapy for Intraocular Retinoblastoma: Alternative Routes, Strategies, and Follow-Up

“…Permanent local adverse events (chorioretinic atrophy and exotropia) were observed in 18.9% of eyes, a lower incidence compared with other reports. 3,23 Statistical analysis did not allow us to associate any adverse event with particular patterns of drug delivery. Concerns remain regarding the toxic effects of irradiation from repeat fluoroscopy in children with retinoblastoma.…”

A New Era of Organ-Preserving Treatment in Pediatric Intraocular Retinoblastoma in Russia: A Multicenter Cohort Study

“…Перераспределение пигмента после СИАХТ может быть связано с предшествующей процедуре отслойкой сетчатки или сосудистой реакцией хори-оидеи на химиотерапию [34,35]. Сосудистой реак-ции ученые определяют ведущую роль в ухудшении зрения, в отдаленном прогнозе этот эффект еще не оценивался.…”