<![CDATA[Introduction: Intra-arterial chemotherapy for retinoblastoma has been widely implemented as a primary or secondary treatment choice, yet its efficacy alone is limited in cases with extensive vitreous seed. The effect of intravitreal chemotherapy combined with intra-arterial chemotherapy on tumor control rates and globe salvage is still uncertain. The objective of this review was to explore the effectiveness and safety of intra-arterial plus intravitreal chemotherapy in retinoblastoma. Methods: A comprehensive search strategy was implemented across three electronic databases (PubMed, Scopus, and Cochrane) for relevant studies from inception until June 2024. Results: Six studies involving 471 eyes were included in the analysis,. Only three studies were comparative. The level of heterogeneity varied across each reported outcomes. The pooled globe salvage rate was 66% (311/471 eyes, 0.78 [95% CI: 0.55, 0.91]). The overall tumor control rate was 83.5% (304/364 eyes, 0.86 [95% CI: 0.74, 0.93]). Metastatic disease occurred in 3 of 471 eyes (0.63%, 0.015 [95% CI: 0.006, 0.036]). Conclusion: The pooled evidence from this meta-analysis supports the efficacy and favorable safety profile of combined intra-arterial and intravitreal chemotherapy in treating retinoblastoma. Further research with extended follow-up period are needed to validate these findings.]]>
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