title: Intravitreal anti-VEGF therapy for macular radiation retinopathy: a 10-year study.
abstract: OBJECTIVE
  To report long-term experience with intravitreal anti-vascular endothelial growth factor treatment for radiation maculopathy.
  
  
  METHODS
  From 2005-2015, 120 consecutive patients underwent intravitreal anti-VEGF therapy for radiation maculopathy. Inclusion criteria included a diagnosis of uveal melanoma treated with plaque radiotherapy and subsequent macular radiation vasculopathy (exudate, retinal hemorrhage, intraretinal microangiopathy, neovascularization, edema). Anti-VEGF therapy involved continuous injections in 4- to 12-week intervals with doses of 1.25 mg/0.05 mL, 2.0 mg/0.08 mL, 2.5 mg/0.1 mL, or 3.0 mg/0.12 mL of bevacizumab as well as 0.5 mg/0.05 mL or 2.0 mg/0.05 mL of ranibizumab. Goals were maintenance of visual acuity and normative macular anatomy. Safety and tolerability (retinal detachment, hemorrhage, infection), visual acuity, central foveal thickness on optical coherence tomography imaging, and clinical features of radiation maculopathy were analyzed.
  
  
  RESULTS
  Progressive reductions in macular edema, hemorrhages, exudates, cotton-wool spots, and microangiopathy were noted. At last follow-up, 80% remained within 2 lines of their initial visual acuity or better, with a mean treatment interval of 38 months (range 6-108 months). Kaplan-Meier analysis of the probability of remaining within 2 lines of initial visual acuity was 69% at 5 years and 38% at 8 years of anti-VEGF therapy. Discontinuation of therapy was rare. Relatively few acute or long-term side effects were noted, allowing for good long-term patient accrual.
  
  
  CONCLUSIONS
  Continuous intravitreal anti-VEGF therapy in patients with radiation maculopathy was well-tolerated and preserved vision. In most cases, reductions or resolution of retinal hemorrhages, cotton-wool spots, and retinal edema were noted for up to 10 years.
authors.affiliation: The New York Eye Cancer Center, New York, New York - USA.|The New York Eye and Ear Infirmary, New York, New York - USA.|New York University School of Medicine, New York, NY - USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
authors.affiliation: The New York Eye Cancer Center, New York, New York - USA.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Chin
authors.affiliation: The New York Eye Cancer Center, New York, New York - USA.|The New York Eye and Ear Infirmary, New York, New York - USA.
authors.forename: Ekaterina A
authors.initials: EA
authors.lastname: Semenova
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D053208:Kaplan-Meier Estimate; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008545:Melanoma / Q000532:radiotherapy; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D000069579:Ranibizumab / Q000627:therapeutic use; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D041623:Tomography, Optical Coherence; D014604:Uveal Neoplasms / Q000532:radiotherapy; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology; D000098943:Uveal Melanoma
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab