September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
DEXAMETHASONE INTRAVITREAL IMPLANT VS INTRAVITREAL RANIBIZUMAB FOR THE TREATMENT OF MACULAR EDEMA SECONDARY TO BRACHYTHERAPY FOR CHOROIDAL MELANOMA
Author Affiliations & Notes
  • Antonio Longo
    Eye Clinic, University of Catania, Catania, Italy
  • Andrea Russo
    Eye Clinic, University of Catania, Catania, Italy
  • Maurizio G Uva
    Eye Clinic, University of Catania, Catania, Italy
  • Caterina Gagliano
    Eye Clinic, University of Catania, Catania, Italy
  • Teresio Avitabile
    Eye Clinic, University of Catania, Catania, Italy
  • Giulia Malaguarnera
    Eye Clinic, University of Catania, Catania, Italy
  • Roberta Amato
    Eye Clinic, University of Catania, Catania, Italy
  • Michele Reibaldi
    Eye Clinic, University of Catania, Catania, Italy
  • Footnotes
    Commercial Relationships   Antonio Longo, None; Andrea Russo, None; Maurizio Uva, None; Caterina Gagliano, None; Teresio Avitabile, None; Giulia Malaguarnera, None; Roberta Amato, None; Michele Reibaldi, None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5022. doi:
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      Antonio Longo, Andrea Russo, Maurizio G Uva, Caterina Gagliano, Teresio Avitabile, Giulia Malaguarnera, Roberta Amato, Michele Reibaldi; DEXAMETHASONE INTRAVITREAL IMPLANT VS INTRAVITREAL RANIBIZUMAB FOR THE TREATMENT OF MACULAR EDEMA SECONDARY TO BRACHYTHERAPY FOR CHOROIDAL MELANOMA. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5022.

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

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Abstract

Purpose : To evaluate the efficacy of intravitreal dexamethasone implant 0.7 mg compared to intravitreal ranibizumab in radiation maculopathy with macular edema secondary to plaque brachytherapy in choroidal melanoma.

Methods : Sixteen eyes diagnosed of radiation maculopathy with macular edema (grade 3-5 according to Horgan classification) secondary to plaque brachytherapy were included in a retrospective study. Eight patients (3 m, 5 f, age range 54-76) were treated with intravitreal ranibizumab and 7 patients (4 m, 4 f, age range 33-78) received dexamethasone intravitreal implant. Visual acuity and foveal thickness using spectral domain optical coherence tomography were evaluated.

Results : In ranibizumab (Ra) and in dexamethasone (Dex) groups, respectively, mean calculated irradiation to the fovea was 5.02±5.44 Gy (range 0-12.4) and 4.78±3.34 Gy (range 0.27-10.27 Gy) (ns), and mean time from brachytherapy to maculopathy development was 21±8 months (range 13-34 months) and 20±5 months (range 14-29 months)(ns) .
In the ranibizumab group (3 eyes with macular edema grade 3, 1 eye with grade 4, and 4 grade 5), mean follow up was 33±15 months (range 7-52 months); patients received a mean number of 7.8±3.9 injections (range 3-13).
In the dexamethasone group (3 eyes with macular edema grade 3, 2 eye with grade 4, and 3 eyes with grade 5), mean follow up was 22±7 months (range 11-31 months) (vs RA p=0.090, Wilcoxon's test), and patients received a mean number of 2.1±0.8 injections (range 1-3) (vs RA p<0.001, Wilcoxon's test).
Mean visual acuity (at baseline: Ra: 0.49±0.14 logMAR; Dex: 0.45±0.18 logMAR) improved significantly in both groups (at last follow-up visit : Ra: 0.34±0.13 logMAR; Dex: 0.27±0.15 logMAR, respectively P=0.012 and P=0.011, Wilcoxon signed rank test). Foveal thickness (at baseline: Ra: 459±74 microns; Dex: 435±72 microns) reduced significantly in both groups (at last follow-up visit: RA: 241±58 microns; Dex: 254±44 microns, both P=0.012, Wilcoxon signed rank test).

Conclusions : Both ranibizumab and dexamethasone are effective treatments for macular edema secondary to plaque brachytherapy for uveal melanoma. Dexamethasone treated patients required less injections to achieve anatomical and functional improvement.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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