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To evaluate the effect of adding topotecan to melphalan for the treatment of retinoblastoma using intra-arterial chemotherapy (IAC). Single-center, consecutive case series. All eyes treated with IAC at the University of Siena, Siena, Italy, from 2008 to2019. Eyes were treated via IAC with either melphalan monotherapy or melphalan plus topotecan. The characteristics and outcomes of these 2 groups were compared. The main outcome measure was globe salvage rate. Additionally, a complete summary of all adverse events for all eyes was compare