July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Prophylactic Intravitreal Bevacizumab after Plaque Radiotherapy for Uveal Melanoma: Analysis of 1311 Eyes of 1310 Patients by Age
Author Affiliations & Notes
  • Michael Chang
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Lauren A Dalvin
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
    Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
  • Li-Anne S Lim
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Mehdi Mazloumi
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Antonio Yaghy
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Arman Mashayekhi
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Carol L. Shields
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Michael Chang, None; Lauren Dalvin, None; Li-Anne Lim, None; Mehdi Mazloumi, None; Antonio Yaghy, None; Arman Mashayekhi, None; Carol Shields, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 721. doi:
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      Michael Chang, Lauren A Dalvin, Li-Anne S Lim, Mehdi Mazloumi, Antonio Yaghy, Arman Mashayekhi, Carol L. Shields; Prophylactic Intravitreal Bevacizumab after Plaque Radiotherapy for Uveal Melanoma: Analysis of 1311 Eyes of 1310 Patients by Age. Invest. Ophthalmol. Vis. Sci. 2019;60(9):721.

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

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Abstract

Purpose : To evaluate the efficacy of intravitreal bevacizumab for prevention of radiation complications after plaque radiotherapy based on age at uveal melanoma diagnosis.

Methods : We performed a retrospective, non-randomized, single-center study of patients treated with prophylactic intravitreal bevacizumab at 4-month intervals from March 2007 to September 2018. Comparisons by age groups were performed using ANOVA, chi-square test, and Kaplan-Meier analysis with SPSS Statistics software.

Results : There were 1311 eyes of 1310 patients treated with prophylactic bevacizumab. Mean age at uveal melanoma diagnosis was 60 years (median 61, range 17-97 years). Patients were divided into three separate age groups: <50 years (n=278), 50-70 years (n=759), or >70 years (n=274). Comparing age groups (<50 vs. 50-70 vs. >70 years), mean tumor thickness at presentation was 4.9 vs. 4.8 vs. 4.7 mm (p=0.58), with mean tumor diameter of 10.9 vs. 11.3 vs. 11.9 mm (p=0.02), and mean distance to foveola of 3.9 vs. 4.1 vs. 4.4 mm (p=0.30). Radiation dose to tumor apex was 71.3 vs. 70.7 vs. 70.3 Gy (p=0.03). Patients were treated with mean of 6 vs. 6 vs. 5 injections (p<0.001) over 27 vs. 27 vs. 21 months (p=0.002). After mean follow-up of 48 vs. 46 vs. 35 months (p<0.001), radiation maculopathy was found in 145 (52%) vs. 326 (43%) vs. 93 (31%) (p<0.001). Radiation papillopathy was found in 68 (24%) vs. 151 (20%) vs. 40 (13%) (p<0.001). Radiation retinopathy was found in 91 (33%) vs. 151 (20%) vs. 40 (13%) (p<0.001). On Kaplan-Meier analysis, the 4-year rate of radiation maculopathy was 51.7% vs. 43.2% vs. 31.1% (p<0.001); the 4-year rate of radiation papillopathy was 25.2% vs. 19.8% vs. 13.4% (p=0.024); and the 4-year rate of radiation retinopathy was 51.7% vs. 43.2% vs. 31.1% (p=0.007).

Conclusions : Following plaque radiotherapy for uveal melanoma and prophylactic intravitreal bevacizumab, radiation maculopathy and papillopathy occurred at a significantly higher rate in younger patients. Future studies to determine whether increased frequency or duration of injections could improve outcomes.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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