Abstract
Purpose :
The use of anti-vascular endothelial growth factor (VEGF) agents for macular edema secondary to radiation from plaque radiotherapy has become a mainstay of treatment. We performed a retrospective, observational clinical study to learn about the structural and visual acuity outcomes in a long-term cohort to study the role of aflibercept in radiation macular edema.
Methods :
We analyzed 27 consecutive patients from University of California, Los Angeles who received aflibercept for radiation retinopathy, specifically macular edema following iodine-125 brachytherapy for choroidal melanoma. Treatment response was evaluated by reviewing best corrected visual acuity (BCVA) and foveal thickness measured by spectral domain optical coherence tomography (SD-OCT).
Results :
Twenty-seven patients received aflibercept injections initiated following development of macular edema secondary to radiation with mean of 8.4 injections (range 1-34) with a mean follow up of 21 months (1-43) following first injection with aflibercept. BCVA at final follow up was 20/155, a statistically significant decline from 20/77 at baseline (p=0.0106). BCVA at one month 20/84 was not statistically significant from baseline (p=0.3805). Baseline mean central subfield thickness was 426 microns. There was improvement in central thickness at one month and final follow-up, with a mean foveal thickness of 399 microns (p=0.1123) and 419 microns (p=0.8609), respectively, though not statistically significant. 30% (8/27) of patients had stable or improved vision from their baseline visual acuity. 48% (13/27) of patients had a final visual acuity of 20/60 or better.
Conclusions :
Aflibercept may not improve visual acuity nor significantly improve SD-OCT foveal thickness in patients who have development symptomatic radiation retinopathy. However, aflibercept may help maintain vision in a small cohort of patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.