March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Intravitreal Bevacizumab As An Adjuvant Agent To Plaque Brachytherapy Reduces Tumor Burden And Enhances The Resolution Of Exudative Detachment
Author Affiliations & Notes
  • Samuel K. Houston
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • Nisha Shah
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • Christina L. Decatur
    Ocular Oncology Lab/Rrsh Associate II, Univ of Miami/Bascom Palmer Eye Inst, Miami, Florida
  • Marcela Lonngi
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • William J. Feuer
    Biostatistics, Univ of Miami-Bascom Palmer, Miami, Florida
  • Timothy G. Murray
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • Footnotes
    Commercial Relationships  Samuel K. Houston, None; Nisha Shah, None; Christina L. Decatur, None; Marcela Lonngi, None; William J. Feuer, None; Timothy G. Murray, None
  • Footnotes
    Support  NIH center grant R01 EY013629, R01 EY12651, and P30 EY014801
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3425. doi:
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      Samuel K. Houston, Nisha Shah, Christina L. Decatur, Marcela Lonngi, William J. Feuer, Timothy G. Murray; Intravitreal Bevacizumab As An Adjuvant Agent To Plaque Brachytherapy Reduces Tumor Burden And Enhances The Resolution Of Exudative Detachment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3425.

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

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Abstract

Purpose: : To evaluate intravitreal bevacizumab as an adjuvant treatment to plaque brachytherapy in the treatment of choroidal melanoma.

Methods: : This is an IRB-approved, retrospective, consecutive case series of 139 patients treated from 2007 - 2009 for choroidal melanoma with plaque brachytherapy. Patients were treated with iodine-125 plaque brachytherapy with 2 mm margins and 85 Gy to the tumor apex. Consecutive patients were injected with 2.5mg/0.1cc bevacizumab at a site away from the primary tumor and immediately following plaque removal. Choroidal melanomas were observed with indirect ophthalmoscopy, wide-angle photography, and ultrasound

Results: : There were 15 cases excluded secondary to lack of documented follow-up, resulting in 124 patients for analysis. Mean patient age was 65.7 years, with mean tumor apical height of 4.0 mm (SD 2.7) and basal diameter of 12.7 mm (SD 3.0). Mean follow-up was 24 months. Prior to treatment, 100% of tumors had exudative retinal detachments, and pre-treatment visual acuity was 20/100. Tumor control was 100% and metastasis was 0% at last follow-up. 89.8% had complete resolution of exudative retinal detachment (ERD), with a mean time to resolution of 3.36 months. At 1 month, 43% had complete resolution of ERD, which increased to 73% at 4 months. Visual acuity improved to 20/40 at 3 months, 20/40 at 6 months, 20/30 at 12 months, and 20/50 at 24 months. Tumor burden was shown to be reduced 22.2% at 3 months, 28.9% at 6 months, 39.3% at 12 months, and 52.2% at 24 months (all P < 0.001). Patients tolerated the procedure well without systemic side effects and minimal local side effects.

Conclusions: : Intravitreal bevacizumab may be used as an adjuvant agent when used following plaque brachytherapy. Treated choroidal melanomas show reduction in tumor burden as well as exudative retinal detachments.

Keywords: tumors • radiation therapy • choroid 
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