Introduction: Retinoblastoma is a rare intraocular malignant tumor of the childhood, growing from unmatured retinal cells, producing early symptoms such as strabismus and leukocoria, the so-called cat-eye sign (white reflecting pupil). The purpose of its treatment include saving the life, the eyeball and finally the best available visual functions. Small tumors can be treated locally laser or cryotherapy, for larger or bilateral lesions chemotherapy is needed, failure of all these necessitates surgical removal of the eyeball.

Aim: To present the technique and results of Intra-arterial Chemotherapy (IAC) achieved in our Institute.

Methods and materials: Chemotherapy can be applied locally to improve efficacy and to reduce side effects by either injecting the drug directly into the eye or trans-arterially through the ophthalmic artery. In collaboration with the Department of Ophthalmology at Semmelweis University Medical School, our Institute was the first, and still is the single provider of selective IAC in Hungary. IAC is completed under general anaesthesia by inserting a 4F guiding catheter from femoral access into the Internal Carotid Artery (ICA), through which a1,5F microcatheter is advanced into the ophthalmic artery to deliver Melphalan and Toptotecan as chemotherapeutic agents.

Results: Since February, 2015, we treated 34 eyes of 31 children. All life and 27 out of the 34 eyes were spared. A minimal residual vision was lost as a consequence of IAC, in one case the treatment must have been interrupted and delayed due to severe vasospasm. There were no more severe complications. Besides of the small caliber of the ophthalmic artery, the angle of its origin, vasospasm related to the microcatheter manipulation, potential dissection and anatomicl variations may create technical difficulties.

Conclusion: IAC is a highly effective treatment method for retinoblastoma, that is capable of saving the eyeball and residual functions in the majority of cases that are diagnosed early.