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Luisa Frizziero, Raffaele Parrozzani, Sara Trainiti, Elisabetta Pilotto, Serena Pulze, Giacomo Miglionico, Edoardo Midena; Intravitreal Dexamethasone Implant in Radiation induced Macular Edema. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4414.
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© ARVO (1962-2015); The Authors (2016-present)
To retrospectively evaluate the efficacy and the therapeutic effect duration of a single intravitreal Dexamethasone implant in patients affected by radiation maculopathy.
Thirteen consecutive eyes of 13 patients affected by radiation maculopathy secondary to eye irradiation for a primary uveal melanoma (Iodine-125 brachitherapy) and treated with a single intravitreal 0.7 mg Dexamethasone implant were retrospectively evaluated. Each patient underwent full ophthalmologic examination, including fluorescein angiography and spectral domain optical coherence tomography (SD-OCT), even in en-face modality. OCT-angiography (OCT-A) was also performed. Follow-up was performed monthly over a six months period.
At pre-injection visit median central subfield thickness (CST) by SD-OCT was 407 µm (interquartile range (IQR), 357-524 µm) and median best-corrected visual acuity (BCVA) was 61 ETDRS score (IQR, 54-67). The median gain of ETDRS letter at one month was 6.5 (IQR, 4-15) (p<0.01). Median CST reduced of 120 µm (IQR, 62-134) (p<0.01). Further CST reduction was reported at two months follow-up, with CST stabilization at three months and maintenance of BCVA. Despite BCVA improvement and CST reduction, OCT-A showed a reduction of foveal capillary density at three months (P>0.05). At four, five and six months follow-up all patients presented new progressive retinal thickening (p<0.01) and BCVA reduction (p<0.01). No side effects were documented.
Intravitreal Dexamethasone implant reduces macular edema secondary to radiation maculopathy also improving visual acuity in a consistent proportion of affected patients, without significant side effects. The duration of the therapeutic effect persists approximately three months. Despite BCVA improvement and CST reduction, macular ischemic changes progress.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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