Thrombophilia in Patients With Retinoblastoma Receiving Ophthalmic Artery Chemosurgery

We have previously reported on our experience of ophthalmic artery chemosurgery (OAC) for the treatment of retinoblastoma,¹ during which heparinization is intended to reduce the risk of thromboemboli forming at the catheter contact site. After femoral artery puncture but prior to catheterization, intravenous heparin is given to reach a target activated coagulation time (ACT) of 200 to 300 seconds (or 2-3 times the baseline), usually achieved with a single bolus of 70 IU/kg. Furthermore, the femoral arterial sheath is slowly flushed with a heparinized saline solution (500 IU of heparin in 500 mL of saline). Since the procedure usually lasts less than 1 hour, no further heparin is given. Herein, we report on 3 patients with heritable thrombophilic conditions: 1 that was known and prophylactically managed prior to catheterization and 2 that were identified following adverse events related to chemosurgery.