INTRAVITREAL BEVACIZUMAB TREATMENT FOR RADIATION MACULAR EDEMA AFTER PLAQUE RADIOTHERAPY FOR CHOROIDAL MELANOMA

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Abstract

Purpose:

To evaluate the effect of intravitreal bevacizumab treatment on patients with macular edema (ME) due to radiation retinopathy after plaque radiotherapy for choroidal melanoma.

Methods:

In this retrospective case series, 10 consecutive patients with ME due to radiation retinopathy after plaque radiotherapy for choroidal melanoma were treated with a single intravitreal injection of bevacizumab. Postinjection best-corrected visual acuity (BCVA) and mean foveal thickness measured by ocular coherence tomography were the primary outcome measures.

Results:

The mean BCVA at the time of the diagnosis of choroidal melanoma was 20/25 (range, 20/20 to 20/40). The mean radiation dose to the foveola was 4,323 cGy (range, 1,908–7,975 cGy). Radiation ME developed at a mean of 26 months (range, 17–44 months) after plaque radiotherapy. Choroidal melanoma regressed in all patients, and there were no neovascular sequelae. At the time of radiation ME diagnosis, the mean BCVA was 20/100 (range, 20/40 to 20/200). After bevacizumab injection, the mean BCVA was 20/86 at 6 weeks and 20/95 at 4 months. Mean foveal thickness measured by ocular coherence tomography was 482 μm before injection, 284 μm 6 weeks after injection, and 449 μm 4 months after injection.

Conclusions:

Intravitreal bevacizumab injection decreases mean foveal thickness while only modestly improving BCVA on a short-term basis in patients with radiation-induced ME.

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