Abstract
Purpose: :
Intravitreal kenalog (IVK) has been shown to be partially effective in treating radiation induced macular edema.1 We investigated the effect of hyperbaric oxygen (HBO) in conjunction with IVK and focal macular laser for treatment of radiation retinopathy.
Methods: :
A 62–year–old Hispanic male was treated for radiation induced macular edema with focal laser, followed 1 month later by IVK (4mg/.1cc), and subsequent treatment for macular ischemia with 18 treatments of HBO.
Results: :
Best–corrected visual acuity was 20/400 before treatment with a foveal thickness of 468 um on OCT. Visual acuity improved to 20/100, 7 weeks s/p IVK and 3 mo s/p focal laser, with a foveal thickness of 132 um. After undergoing HBO treatment, his visual acuity continued to improve to 20/50, 4 mo s/p IVK, with a stable foveal thickness and increased macular perfusion.
Conclusions: :
Though it is unclear if focal laser had any definite effect, IVK resulted in marked improvement in macular thickness, returning it to normal, and increased vision. While receiving HBO treatment, the vision improved further while the macular OCT remained stable. IVK with HBO treatment improved the visual angle by 800% and decreased macular thickness in this patient with radiation retinopathy. Further evaluation of HBO treatment in these patients with macular ischemia is warranted. 1Sutter, FK, Gillies MC. Intravitreal triamcinolone for radiation–induced macular edema. Arch Ophthalmol 2003 Oct; 121 (10):1491–3.
Keywords: ischemia • macula/fovea • radiation damage: light/UV