Purpose Review our experience in the use of indocyanine green (ICG) enhanced transpupillary thermotherapy (TTT) in combination with ophthalmic artery chemosurgery for retinoblastomas unresponsive to standard TTT.

Methods Single centre, retrospective study of 16 eyes in 13 retinoblastoma patients treated with TTT and ICG via indirect ophthalmoscope: 23 treatments of 16 eyes, with a mean follow-up of 12.1 months (range 3–35 months). Outcome measures included tumour response and electroretinogram.

Results Treatment resulted in significant tumour regression in all eyes: 13 eyes with well-differentiated characteristics, 2 with implanting vitreous seeds and 1 eye refractory to traditional TTT. ERG function was retained in all eyes.

Conclusions ICG-enhanced TTT with ophthalmic artery chemosurgery can effectively treat retinoblastoma refractory to conventional focal treatments without deleterious ocular side effects.