title: Novel treatment for radiation optic neuropathy with intravenous bevacizumab.
abstract: Radiation optic neuropathy is a devastating form of vision loss that can occur months to years after radiation therapy for tumors and other lesions located in close proximity to the visual pathways. We present the case of a 24-year-old woman who underwent external beam radiation for treatment of a tectal pilocytic astrocytoma, and 5 years later she developed bilateral radiation optic neuropathy and radiation necrosis of the right temporal lobe. We opted to treat her with intravenous bevacizumab with 3 doses every 3 weeks, as well as dexamethasone and pentoxifylline. After the first infusion of bevacizumab, the patient noted improvement in vision and color vision, and a follow-up magnetic resonance imaging study showed that the previous enhancement of the optic nerves and chiasm was diminishing. Her vision improved dramatically and has remained stable over a 3-year period.
authors.affiliation: School of Medicine, Department of Neurology, University of Buffalo, Buffalo, New York, USA.
authors.forename: Osman
authors.initials: O
authors.lastname: Farooq
authors.forename: Norah S
authors.initials: NS
authors.lastname: Lincoff
authors.forename: Nicolas
authors.initials: N
authors.lastname: Saikali
authors.forename: Dheerendra
authors.initials: D
authors.lastname: Prasad
authors.forename: Robert S
authors.initials: RS
authors.lastname: Miletich
authors.forename: Laszlo L
authors.initials: LL
authors.lastname: Mechtler
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D001254:Astrocytoma / Q000150:complications / Q000532:radiotherapy / Q000601:surgery; D000068258:Bevacizumab; D001766:Blindness / Q000209:etiology; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000601:surgery; D060733:Electromagnetic Radiation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009901:Optic Nerve Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D011832:Radiation Injuries / Q000150:complications*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab