Intra-arterial chemotherapy for treatment of very low birthweight infants with retinoblastoma: Two case reports

INTRODUCTION: Intra-arterial chemotherapy (IAC) has been used successfully for unilateral and bilateral eye disease with advanced or less advanced intraocular disease and of children as young as 3 months of age. In this study, we expanded the use of IAC to eyes of two infants with very low birthweight (birth weight of 1000–1500 g) and retinoblastoma. PATIENT CONCERNS: The ophthalmologists refused to give patients intravenous chemotherapy (IVC), considering the risk of IVC because of the low body weight. DIAGNOSIS: Two patients were diagnosed unilateral eye retinoblastoma at 31 days old and 27 days old respectively when newborn fundus screening. INTERVENTIONS: Chemotherapeutic agents were injected into the ophthalmic artery during the four IAC session. The two patients’ oculars were preserved due to calcification during follow-up periods to the final IAC. OUTCOMES: Complications included eyelid edema in the patient #1 and neutropenia in both patients. No fever, sepsis and other systemic toxic effects were observed. After two successful IAC treatment for each patient, their oculars were all preserved without serious complications. LESSONS: Our center for the first time reported the management of retinoblastoma in very low birthweight infants with especially challenging and we recommend this to be useful to the patient community.