Anti-VEGF bevacizumab (Avastin) for radiation optic neuropathy.
OBJECTIVE
To evaluate intravitreal bevacizumab treatment for radiation optic neuropathy (RON).


METHODS
Interventional case report.


METHODS
At The New York Eye Cancer Center, a patient symptomatic of decreased vision because of RON was treated with intravitreal bevacizumab (1.25 mg). Main outcome measures included visual acuity, appearance of the optic nerve, fundus photography, angiography, and optical coherence tomography/scanning laser ophthalmoscopy (OCT/SLO).


RESULTS
Within one week, her vision improved from 20/32 to 20/20 with a reduction in optic disk hemorrhage. At six weeks, evidence of both decreased hemorrhage and optic disk edema was documented by photography, angiography, and OCT/SLO. At the three and five-month follow-up visits, the hemorrhages resolved, and her disk margins were sharp. There were no ocular or systemic side effects.


CONCLUSIONS
Intravitreal bevacizumab was tolerated, improved vision, and reduced hemorrhage as well as optic disk edema (angiographic leakage). Anti-VEGF therapy (e.g. bevacizumab) should be investigated for both ocular and nonocular radiation neuropathy.
Finger
Paul T
PT
New York Eye Cancer Center, New York, New York 10021, USA. pfinger@eyecancer.com
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001918:Brachytherapy / Q000009:adverse effects; D002830:Choroid Neoplasms / Q000532:radiotherapy; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008545:Melanoma / Q000532:radiotherapy; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000528:radiation effects*; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D011832:Radiation Injuries / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab