Intravitreal Bevacizumab at 4-Month Intervals for Prevention of Macular Edema after Plaque Radiotherapy of Uveal Melanoma

Optical Coherence Tomography Angiography of the Macula After Plaque Radiotherapy of Choroidal Melanoma

“…Radiation parameters included radiation dose (cGy) to the tumor apex, tumor base, foveola, and optic disc. Subsequent treatments for tumor consolidation (transpupillary thermotherapy) and prevention of radiation side effects (intravitreal bevacizumab injection 15 and sector panretinal laser photocoagulation 16,17 ) were documented. In addition, history or presence of radiation complications such as radiation maculopathy without macular edema, radiation maculopathy with macular edema (both cystoid and noncystoid), and radiation papillopathy were recorded.…”

“…The largest and smallest FAZ diameters were subjectively identified, knowing that the normal FAZ was minimally irregular and variable in size. 15 The edge points were manually selected along the centerline of the vessels to determine FAZ area.…”

Early Subclinical Macular Edema in Eyes with Uveal Melanoma: Association with Future Cystoid Macular Edema

“…16e18 Our findings also allow identification of eyes with uveal melanoma that are at higher risk for future CME and may benefit from prophylactic treatment aimed at reducing intraocular levels of proinflammatory factors such as VEGF. 2 Further studies are needed to explore the correlation between levels of proinflammatory cytokines and presence of subclinical macular edema or CME in eyes with uveal melanoma.…”

“…1,2 In a study on 135 patients with uveal melanoma followed for a median of 24 months after I-125 plaque radiation, Horgan et al 1 found evidence of macular edema by timedomain optical coherence tomography (OCT) in 70% of treated eyes. The mean time to onset of macular edema in their study was 12 months, 5 months shorter than the mean time to onset of clinical radiation maculopathy.…”

Intravitreal Aflibercept as Rescue Therapy for Post-Radiation Cystoid Macular Edema Resistant to Intravitreal Bevacizumab: Outcomes at 1 Year

“…Shah et al [12] found that the use of IVB (1.25 mg) at 4-month intervals following plaque radiotherapy reduced the rate of OCT-evident CME (26 vs. 40%) and moderate vision loss (15 vs. 28%) in treated versus untreated eyes at 2 years, offering clinicians a possible preventative strategy. Moreover, a recent report identified that eyes with subclinical macular edema (greater than a 10-μm difference in CMT between the affected and fellow eye) at baseline were more likely to develop CME after radiation ( p = 0.005; hazard ratio 1.77), offering clinicians an OCT-based criterion to identify high-risk eyes [4].…”