May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Bevacizumab After Brachitherapy for Choroidal Malignant Melanoma
Author Affiliations & Notes
  • E. Midena
    Ophthalmology, University of Padova, Padova, Italy
    Fondazione GB Bietti per l'Oftalmologia, IRCCS, Roma, Italy
  • E. Pilotto
    Ophthalmology, University of Padova, Padova, Italy
  • R. Parrozzani
    Ophthalmology, University of Padova, Padova, Italy
  • V. de Belvis
    Ophthalmology, University of Padova, Padova, Italy
  • P. P. Radin
    Ophthalmology, University of Padova, Padova, Italy
  • S. Vujosevic
    Ophthalmology, University of Padova, Padova, Italy
    Fondazione GB Bietti per l'Oftalmologia, IRCCS, Roma, Italy
  • Footnotes
    Commercial Relationships E. Midena, None; E. Pilotto, None; R. Parrozzani, None; V. de Belvis, None; P.P. Radin, None; S. Vujosevic, None.
  • Footnotes
    Support Fondazione GB Bietti per l'Oftalmologia, IRCCS, Roma
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 5758. doi:
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    • Get Citation

      E. Midena, E. Pilotto, R. Parrozzani, V. de Belvis, P. P. Radin, S. Vujosevic; Bevacizumab After Brachitherapy for Choroidal Malignant Melanoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5758.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To report the effects of bevacizumab (a non-selective anti vascular endothelial growth factor drug) in the treatment of persistent serous retinal detachment after brachytherapy for choroidal melanoma.

Methods:: Twenty eyes of twenty consecutive patients affected by persistent (> 6 months) or progressing serous retinal detachment after successful Iodine125 brachytherapy for medium/large choroidal melanoma underwent bevacizumab intravitreal injection (1.25mg in 0.05mL). Injection was repeated at 3 months interval if serous detachment persisted or progressed. Fundus photography, and A and B scan ultrasound were performed. OCT was performed when serous detachment involved the posterior pole. Four eyes had also iris neovascularization at baseline.

Results:: All tumors showed significant regression after brachytherapy (thickness: 5.8 ± 2.8 mm vs 4.1 ± 2.2 mm, p< 0.03). Mean follow-up after intravitreal injection was 9.2 ± 2.2 months. Serous detachment fully regressed in 18 of 20 (90%) bevacizumab treated eyes, with 1.5 mean number of injections. Iris neovascularization completely disappeared after one bevacizumab injection in 4 out of 4 eyes. No local or general complications were observed.

Conclusions:: Persisting or progressing serous retinal detachment after brachytherapy for choroidal melanoma is a significant risk factor for severe visual loss and neovascular glaucoma. Vascular endothelial growth factor plays a major role in neoplastic and post-radiation serous retinal detachment. Intravitreal bevacizumab seems to be a promising approach in the treatment of these high-risk eyes.

Keywords: melanoma • retinal detachment • drug toxicity/drug effects 
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