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Introduction Uveal melanoma may be treated by a number of radiotherapy techniques including proton beam therapy, stereotactic radio-surgery and ruthenium plaque brachytherapy. The main side effect of such therapy is visual loss secondary to radiation retinopathy or optic neuropathy.
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Introduction Uveal melanoma may be treated by a number of radiotherapy techniques including proton beam therapy, stereotactic radio-surgery and ruthenium plaque brachytherapy. The main side effect of such therapy is visual loss secondary to radiation retinopathy or optic neuropathy. INTRA-VITREALANTI-VEGF INJECTION FOR RADIATION RETINOPATHY/NEUROPATHYMG ZAYED, K SEARS, PA RUNDLE, IG RENNIEOphthalmology Department, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust Conclusion Intra-vitreal anti-VEGF therapy was associated with improvement in the clinical features and symptoms related to radiation retinopathy/neuropathy. No ocular or systemic side effects were noted. This study supports the current evidence on the role of Anti-VEGF therapy for radiation retinopathy/neuropathy1-2. Purpose To report the outcome of Anti-VEGF treatment for radiation retinopathy/neuropathy and symptomatic changes experienced by patients. Results Table Methods Five Patients with radiation related retinopathy/neuropathy that developed after a mean period of 27 months of radiotherapy (minimum of 4 and maximum of 66) were treated with courses of 3 intravitreal injections of bevacizumab (1.25mg). Outcome measures included best corrected visual acuity, symptomatic improvement, fundal appearance and optical coherence tomography. Results All 5 patients experienced a symptomatic improvement along with an improved mean visual acuity of 3 lines on snellen chart (minimum of 1 and maximum of 5). Also they demonstrated clinical findings of decreased intra-retinal hemorrhages, cotton-wool spots, and retinal edema. There were no significant ocular or systemic side effects. Figure 1A Case 1: Fundus photograph showing Left Eye Choroidal Melanoma Figure 1B Case 1: Fundus photograph showing Optic neuropathy 35 months post radiotherapy Figure 1C Case 1: Fundus photograph Showing resolution of optic neuropathy post anti-VEGF injection References: Finger PT, Chin KJ ., Anti-vascular endothelial growth factor bevacizumab for radiation optic neuropathy: secondary to plaque radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2012 Feb 1;82(2):789-98. doi: 10.1016/j.ijrobp.2010.11.075. Mason JO 3rd et al., Intra-vitrealbevacizumab treatment for radiation macular edema after plaque radiotherapy for choroidal melanoma. Retina. 2007 Sep;27(7):903-7
