Author Affiliations: Ocular Oncology Service, Wills Eye Institute (Drs C. L. Shields, Ramasubramanian, and J. A. Shields) and Division of Neurovascular and Endovascular Surgery, Department of Neurosurgery (Dr Jabbour), Thomas Jefferson University, and Department of Radiation Oncology, Drexel University College of Medicine and Hahnemann University Hospital (Dr Emrich), Philadelphia, Pennsylvania; and Department of Internal Medicine, St Vincent Hospital, Worcester, Massachusetts (Dr Vijayakrishnan).
We are disappointed by the misleading comments published by Gobin and colleagues on radiation exposure during IAC for retinoblastoma. Similar to other reports by their group, a consistent effort to underemphasize potential problems of IAC is evident. These problems include retinoblastoma recurrence, ischemic retinal and choroidal effects from chemotherapy and catheterization, and retinoblastoma metastasis, and now there is an effort to downplay the potential risk for radiation exposure. One concept we all agree on is that fluoroscopy exposes these children to radiation. Exactly how much radiation is dependent on several factors. The singular goal of our article1 was to explore the fluoroscopy risks in these young children, some with germline mutation. To our knowledge, this was not previously determined and was an important concern for those using IAC.
Shields CL, Vijayakrishnan R, Ramasubramanian A, Emrich J, Jabbour P, Shields JA. Radiation Exposure During Intra-arterial Chemotherapy for Retinoblastoma—Reply. Arch Ophthalmol. 2012;130(3):403-405. doi:10.1001/archopthalmol.2012.173