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G. Gupta, J. Nielsen, R. Schroeder; Intravitreal Bevacizumab (Avastin) for the Treatment of Macular Edema Secondary to Radiation From Iodine-125 Brachytherapy for Choriodal Melanomas. Invest. Ophthalmol. Vis. Sci. 2007;48(13):252.
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To examine the efficacy of intravitreal bevacizumab (Avastin, Genetech, Inc., San Francisco, CA) for the treatment of ischemic macular edema secondary to radiation from iodine-125 brachytherapy for choriodal melanomas.
Retrospective chart review of 2 patients previously treated for choriodal melanomas with iodine-125 brachytherapy and who had macular edema on both clinical exam and optical coherence tomography (OCT) scan. Both patients were treated with 1.25 mg of intravitreal bevacizumab and then followed for 3 months. Patients underwent a pre-injection OCT scan and fluorescein angiography. Monthly OCT scans were then obtained for a total of three months. The primary outcome measure was retinal surface contour map and thickness as measured by OCT. Secondary outcome measure was vision.
Neither patient had any significant improvement in macular edema 3 months post injection. Macular thickness and contour maps remained essentially unchanged. The patients’ pre-injection visual acuity was 20/400 and 20/60: both remained unchanged during the course of treatment.
Intravitreal bevacizumab may not be beneficial in the treatment of macular edema secondary to radiation retinopathy. This effect may be due the ischemic nature of the edema and prompts the need for further exploration into the efficacy and safety of using anti-angiogenic compounds in the treatment of macular edema from ischemic etiologies.
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