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Retinoblastoma has gone from >95% mortality to >95% survival in the past 100 years. Once enucleation techniques were perfected, the majority of children survived, but without the eye (or vision in that eye). Over the past 100 years, progressively better techniques have been developed for salvaging vision without sacrificing patient survival. Presently, 99% of children treated at our center survive their cancer, >99% retain at least one eye, and >90% retain normal vision in at least one eye. The introduction of ophthalmic artery chemosurgery has been the most dramatic, non-radiation-based mode to maximally preserve vision.
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Supplemental Video 1: A 450-micron catheter is passed from the femoral artery up through the abdominal aorta, thoracic aorta, and internal carotid artery on the side to be treated. Supplemental Video 2: The catheter is passed through the carotid artery on the side to be treated beyond the exit of the ophthalmic artery. The catheter is not passed directly into the ophthalmic artery at this point. Supplemental Video 3: The catheter is then pulled back, and because it is a flow-guided catheter, it enters the orifice of the ophthalmic artery. Contrast dye confirms the position and the choroidal blush of the eye is clearly seen.