Peru, an upper-middle income country according to the World Bank, is being severely affected by the COVID-19 pandemic, counting today 285 213 cases and 9677 deaths, and having one of the highest incidence rates of COVID-19 in the world (87.5 per million inhabitants). 1 National lockdown policies, transportation restriction, and economic constrains, along with disrupted health care services, have significantly impacted access for diagnosis and treatment of children with cancer. 2,3 Although recent papers suggest that the pediatric oncology population may not have higher mortality resulting from SARS-CoV-2 infection in high-income countries (Spain, 4 China, 5 USA, 6 Italy 7), these patients

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Local therapies are increasingly used for ocular preservation in retinoblastoma. In middle‐income countries, these techniques pose specific challenges mostly related to more advanced disease at diagnosis. The Grupo de America Latina de Oncología Pediátrica (GALOP) developed a consensus document for the management of conservative therapy for retinoblastoma. Intra‐arterial chemotherapy (OAC) is the preferred therapy, except for those with less advanced disease or age younger than 6 months. OAC allowed for a reduction in the use of external beam radiotherapy in our setting. Intravitreal chemotherapy is the preferred treatment for vitreous seeding. Enucleation is the treatment of choice for eyes with advanced disease.

Local therapies replaced systemic chemotherapy for ocular preservation in retinoblastoma. In middle income countries, these techniques pose specific challenges mostly related to more advanced disease at diagnosis. The Grupo de America Latina de Oncologia Pediatrica (GALOP developed a consensus document for the management of conservative therapy for retinoblastoma. Intra-arterial chemotherapy (OAC) is the preferred therapy, except those with less advanced disease or age younger than 6 months. OAC allowed for the elimination of the use of external beam radiotherapy in our setting. Intravitreal chemotherapy is the preferred treatment for vitreous seeding. Enucleation is the treatment of choice for advanced eyes.