June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Intravitreal anti-VEGF therapy has limited benefit in treating radiation retinopathy following iodine-125 radiotherapy for the treatment of choroidal melanoma
Author Affiliations & Notes
  • Elisha C Garg
    David Geffen School of Medicine at UCLA, Los Angeles, CA
  • Peter Custis
    Kaiser Permanente, San Diego, CA
  • Robert E. Engstrom
    Jules Stein Eye Institute, Los Angeles, CA
    Valley Retina Associates, Encino, CA
  • Scott Grant
    Retina Consultants of Orange County, Fullerton, CA
  • Glen Jarus
    Glen D Jarus MD Inc, West Covina, CA
  • Richard Pesavento
    Retina Consultants of Southern California, Loma Linda, CA
  • Dante Joseph Pieramici
    California Retina Consultants, Santa Barbara, CA
  • Colin A McCannel
    Jules Stein Eye Institute, Los Angeles, CA
  • Tara A. McCannel
    Jules Stein Eye Institute, Los Angeles, CA
  • Footnotes
    Commercial Relationships Elisha Garg, None; Peter Custis, None; Robert Engstrom, None; Scott Grant, None; Glen Jarus, None; Richard Pesavento, None; Dante Pieramici, None; Colin McCannel, None; Tara McCannel, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 3445. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Elisha C Garg, Peter Custis, Robert E. Engstrom, Scott Grant, Glen Jarus, Richard Pesavento, Dante Joseph Pieramici, Colin A McCannel, Tara A. McCannel; Intravitreal anti-VEGF therapy has limited benefit in treating radiation retinopathy following iodine-125 radiotherapy for the treatment of choroidal melanoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3445.

      Download citation file:

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

  • Supplements

Purpose: Although the use of anti-vascular endothelial growth factor (VEGF) inhibitors has emerged as a common treatment for radiation macular edema following plaque radiotherapy for choroidal melanoma, studies evaluating long-term protective benefits of bevacizumab in vision and macular edema are limited. We performed a retrospective consecutive review to elucidate the outcomes and efficacy duration of the intravitreal anti-VEGF agent bevacizumab in patients who developed radiation retinopathy following iodine-125 brachytherapy for local treatment of choroidal melanoma.

Methods: All patients at the Ophthalmic Oncology Center at the Stein Eye Institute who received at least one intravitreal anti-VEGF in the form of bevacizumab, for the treatment of radiation retinopathy evidenced by macular edema following iodine-125 brachytherapy for the treatment of choroidal melanoma from 2001-2013 were included. Patient and baseline tumor characteristics were recorded; treatment response was evaluated by reviewing best recorded Snellen visual acuity (BRVA) and foveal thickness measured by spectral domain optical coherence tomography (SD-OCT).

Results: Forty-two patients received bevacizumab injection initiated at a mean of 38 months (range 3-310) following iodine-125 brachytherapy with a mean of 5 injections (range 1-18) over 8 months with mean follow-up time of 19 months (range 1-66) following first injection. BRVA at final follow-up was 20/215, a statistically significant decline from a pre-injection baseline of 20/76 (p=0.0056). BRVA at one month was 20/74, not statistically different from baseline (p=0.9348). Baseline mean SD-OCT foveal thickness was 440 mm. No differences in foveal thickness were found at one month or final follow-up, with mean foveal thicknesses of 382 mm (p=0.1180) and 387 mm (p=0.1535), respectively.

Conclusions: Bevacizumab may not improve visual acuity nor SD-OCT foveal thickness in patients who develop radiation retinopathy with macular edema. Any benefits of anti-VEGF therapy with bevacizumab appear to not be sustained.


This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.