Question

Discuss the technique and complications of intra-arterial chemotherapy in retinoblastoma.

Hint:

Intra-arterial chemotherapy is highly effective for retinoblastoma, but careful monitoring is essential to manage potential complications such as ocular toxicity and infection.

Answer 1

Step 1: Technique of Intra-Arterial Chemotherapy:
Intra-arterial chemotherapy for retinoblastoma involves the direct administration of chemotherapy agents into the ophthalmic artery. The technique involves the following steps:
1. Catheter Placement: A catheter is inserted into the femoral artery, and under fluoroscopic guidance, it is navigated to the ophthalmic artery.
2. Drug Injection: Chemotherapy agents are injected directly into the ophthalmic artery, targeting the tumor while minimizing systemic toxicity.
3. Monitoring: The procedure is closely monitored through angiography and imaging to ensure proper drug delivery and check for any complications.

Step 2: Complications of Intra-Arterial Chemotherapy:
Complications may include:
1. Ocular Toxicity: Localized toxicity to the retina or optic nerve can occur, leading to visual impairment.
2. Vascular Complications: These include catheter-related complications, arterial dissection, or hemorrhage.
3. Systemic Toxicity: Although rare, there may be systemic side effects, including myelosuppression or nephrotoxicity.
4. Infection: Infection at the catheter insertion site is a potential risk.