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Ophthalmic artery catheterization for retinoblastoma treatment: does reflux affect tumor response?
  1. Ahmad Sweid1,
  2. Batoul Hammoud2,
  3. Joshua H Weinberg1,
  4. Pavlos Texakalidis3,
  5. Vivian Xu1,
  6. Kavya Shivashankar1,
  7. Michael P Baldassari1,
  8. Somnath Das1,
  9. Stavropoula I Tjoumakaris1,
  10. Carol L Shields4,
  11. David A Lezama4,5,
  12. Li-Anne S Lim4,
  13. Lauren A Dalvin4,6,
  14. Kareem El Naamani7,
  15. Pascal Jabbour1
  1. 1 Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  2. 2 Department of Pediatric Endocrinology, Children Hospital of Philadelphia, Philadelphia, Pennsylviania, United States
  3. 3 Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
  4. 4 Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
  5. 5 Instituto de Oftalmologia y Ciencias Visuales, Tecnologico de Monterrey, Monterrey, Mexico
  6. 6 Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
  7. 7 School of Medicine, Lebanese American University, Beirut, Beirut, Lebanon
  1. Correspondence to Dr Pascal Jabbour, Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107-5084, USA; pascal.jabbour{at}


Background Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has been established as a primary treatment for the disease. To determine whether the presence of reflux into the ICA is associated with tumor response or with any other adverse events in pediatric retinoblastoma patients.

Methods A retrospective chart review was performed for patients diagnosed with Rb and managed with ophthalmic artery catheterization (OAC).

Results The total study cohort included 205 Rb tumors of 205 eyes in 194 consecutive patients who underwent 624 successful intra-arterial chemotherapy infusions using OAC. Of the 205 eyes, 65 eyes (32.7%) underwent 157 OAC procedures constituted group A (no reflux), 64 eyes (31.2%) underwent 236 OAC procedures constituted group B (variable pattern), and 74 eyes (36.1%) underwent 231 OAC procedures constituted group C (reflux). There was no significant difference in baseline characteristics between the three cohorts. Also, there was no significant difference in tumor characteristics between the three groups, except for genetic status. There was no significant difference between the three groups in terms of tumor response at completion of the treatment regimen. Complete tumor response was achieved at 70.2% in Group A, at 83.3% in Group B, and at 78.5% in group C (P=0.39). Similarly, eye enucleation occurred at 38.5% in group A, 31.8% in group B, and 31.5% in group C. None of the patients in both groups had any neurological adverse events or new onset of seizures.

Conclusions The presence of reflux, which may complicate the procedure and prolong it, was not associated with poor outcomes in our analysis.

  • tumor
  • pediatrics
  • orbit

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  • Contributors Contributorship Statement: Conception or design of the work: AS, CLS, PJ. Acquisition of data: AS, VX, KS, MPB, SD, LAD, JHW, KEN. Analysis of data: PT. Interpretation of data: AS, PT, DAL. Drafting the work: AS, BH. Revising the work for valuable intellectual content: PJ, SR, CLS, L-ASL, SIT. Final approval of the version: PJ.

  • Funding The study was approved by Thomas Jefferson University Institutional Review Board (12D:534). Patient consent was waived due to the retrospective nature of the study, and all data was deidentified.

  • Competing interests PJ is a consultant for Medtronic and MicroVention. SIT is a consultant for Stryker. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.