Advances in Retinoblastoma Treatment Comprehensive Management and Frontier Exploration of Eye-Preserving Strategies

College of Optometry Clinic, Tianjin Medical University, 300450, Tianjin, China

^* Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Retinoblastoma is the most common intraocular malignancy in children, and its treatment goal has evolved from life-saving to eye-preserving and vision-preserving approaches. In recent years, intra‑arterial chemotherapy (OAC) and intravitreal chemotherapy (IViC) have greatly improved eye‑preservation rates, especially in advanced cases. This paper systematically summarizes the efficacy, indications and technical advances of systemic chemotherapy, focal therapy, OAC and IViC in eye‑preserving management. Clinical outcomes demonstrate that OAC achieves significantly higher eye‑survival rates than systemic chemotherapy in stage D retinoblastoma, while IViC provides effective control for vitreous seeding, the major cause of treatment failure. Multimodal combination regimens further improve salvage outcomes in refractory and recurrent cases. However, challenges remain, including toxicity, limited vision recovery, technical accessibility, and heterogeneous protocols. This paper also discusses the future directions, such as targeted therapy, immunotherapy, gene therapy, and visual rehabilitation. Individualized multimodal therapy is key to achieving survival, eye preservation and functional vision simultaneously.