Monthly intravitreal bevacizumab for macular edema after iodine-125 plaque radiotherapy of uveal melanoma.
OBJECTIVE
To examine the efficacy of monthly injections of intravitreal bevacizumab (IVB) for macular edema after iodine-125 plaque radiotherapy of uveal melanoma.


METHODS
We studied 36 patients with macular edema after plaque radiotherapy of uveal melanoma in this noncomparative, interventional case series. All eyes were treated with 4 monthly injections of IVB. Central macular thickness (CMT) and best-corrected visual acuity (BCVA) were measured before each injection and 4-6 months after the first injection. The main outcome measures were change in CMT and BCVA.


RESULTS
At 4-6 months following the first IVB, 20 eyes (56%) had decreased CMT, 11 eyes (31%) had stable CMT, and 5 eyes (14%) had increased CMT. The mean change in CMT and the mean percent change in CMT at 4-6 months compared to baseline were -91 µm (-20%) in all eyes, -174 µm (-37%) in the group with decreased macular thickness, -14 µm (-3%) in the group with stable macular thickness, and +69 µm (+17%) in the group with increased macular thickness. At 4-6 months, 15 eyes (42%) had increased BCVA, 16 eyes (44%) had stable BCVA, and 5 eyes (14%) had decreased BCVA. An increase in CMT was seen between the fourth monthly IVB injection and the final evaluation at 4-6 months after the first injection in all 3 groups of our study.


CONCLUSIONS
At 4-6 months following the first injection, 4 monthly injections of IVB in eyes with macular edema after plaque radiotherapy of uveal melanoma decreased macular edema in 56% and improved BCVA in 42% of the treated eyes.
1 Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania - USA.
Arman
A
Mashayekhi
Duangnate
D
Rojanaporn
Saad
S
Al-Dahmash
Carol L
CL
Shields
Jerry A
JA
Shields
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D001918:Brachytherapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008545:Melanoma / Q000532:radiotherapy*; D008875:Middle Aged; D011832:Radiation Injuries / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012160:Retina / Q000503:physiopathology / Q000528:radiation effects*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000532:radiotherapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D000098943:Uveal Melanoma
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D007457:Iodine Radioisotopes; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab