To the Editor Our team read with interest the article by Yannuzzi et al1 about enucleation vs ophthalmic artery chemosurgery (OAC) as primary treatment for advanced-stage retinoblastoma. This is an important article reviewing the outcome of patients who received OAC. We wonder whether their conclusions should have greater caution regarding the confidence in them, given the relatively small number of cases evaluated (resulting in relatively high uncertainty regarding the precise outcomes) and the risk of selection bias of cases that were evaluated.