title: Intravitreal anti-VEGF bevacizumab (Avastin) for external beam related radiation retinopathy.
abstract: OBJECTIVE
  To report on intravitreal bevacizumab treatment for external beam radiation therapy (EBRT)-related radiation maculopathy.
  
  
  METHODS
  Three patients (4 eyes) with EBRT-related maculopathy were treated with periodic (4- to 8-week) intravitreal injections of bevacizumab (1.25 mg in 0.05 cc). Outcome measures included best-corrected Early Treatment Diabetic Retinopathy Study visual acuity, retinal examination, fundus photography, fluorescein angiography, and optical coherence tomography.
  
  
  RESULTS
  Patients were diagnosed with Stage 3 radiation maculopathy occurring 12, 19, and 48 months after irradiation. One received 50 Gy of 6-MV photon EBRT for a maxillary carcinoma, the second 30.6 Gy of 6-MV photon EBRT for intraocular lymphoma, and the third 72 Gy proton beam irradiation for adenoid cystic carcinoma of the lacrimal gland. With up to 33 months follow-up, visual acuities improved (8 and 11 letters) in 2 eyes, gained 5 letters in 1 eye and 1 decreased 5 letters from 20/16 to 20/20. All cases demonstrated clinical findings of decreased intraretinal hemorrhages, cotton-wool spots, and retinal edema. There were no significant ocular or systemic side effects.
  
  
  CONCLUSIONS
  Intravitreal anti-VEGF therapy was associated with reductions of EBRT-related retinopathy. No ocular or systemic side effects were noted. Anti-VEGF therapy may be considered radiation maculopathy secondary to EBRT.
authors.affiliation: The New York Eye Cancer Center, New York, New York 10065, USA. pfinger@eyecancer.com
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
authors.forename: Sri Krishna
authors.initials: SK
authors.lastname: Mukkamala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D005134:Eye Neoplasms / Q000532:radiotherapy; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D008297:Male; D011832:Radiation Injuries / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab