The efficacy of focal laser therapy in radiation-induced macular edema.
OBJECTIVE
The purpose of the study was to determine whether focal laser therapy improves or prevents deterioration of visual acuity in radiation-induced macular edema.


METHODS
Retrospective review.


METHODS
The chart review of 19 patients.


METHODS
Comparison of 19 patients with radiation-induced macular edema secondary to radioactive scleral plaque application for choroidal melanoma managed by focal laser therapy with a matched group of 23 similar patients followed by observation.


RESULTS
Doubling of the visual angle occurred in 68% of all cases with 2 years of follow-up. At 6 months, 8 of 19 (42%) treated but no observed cases experienced > or = 1 Snellen line improvement in visual acuity (P = 0.005, Fischer's exact test), and the visual angle was halved in 3 of 19 (16%) treated but no observed cases at 6 months (P = 0.069). Resolution of macular edema occurred at 6 months in 5 of 19 (26%) treated and 1 of 23 (4%) observed cases (P = 0.21). No significant difference in visual acuity between the two groups was present after 2 years.


CONCLUSIONS
Progressive visual loss secondary to radiation-induced macular edema is rapid and severe. Focal laser therapy may modestly improve visual acuity and promote resolution of macular edema at 6 months, but benefit from single treatment is not sustained at 2 years.
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D002830:Choroid Neoplasms / Q000532:radiotherapy; D004487:Edema / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D053685:Laser Therapy; D008266:Macula Lutea / Q000503:physiopathology / Q000528:radiation effects / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000532:radiotherapy; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012164:Retinal Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology; D014792:Visual Acuity