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INTRAVITREAL DEXAMETHASONE 0.7-MG IMPLANT FOR RADIATION MACULAR EDEMA AFTER PROTON BEAM THERAPY FOR CHOROIDAL MELANOMA

Baillif, Stéphanie MD, PhD; Maschi, Celia MD; Gastaud, Pierre MD, PhD; Caujolle, Jean Pierre MD

doi: 10.1097/IAE.0b013e31829234fa
Original Study

Purpose: To evaluate the efficacy of dexamethasone 0.7-mg intravitreal implant in patients with radiation macular edema after proton beam therapy for choroidal melanoma.

Methods: Five patients' charts were retrospectively reviewed. The main outcome measures were visual acuity and mean central retinal thickness.

Results: All patients received a radiation dose of 60 cobalt gray equivalent. Radiation macular edema occurred within a mean time of 26 months after irradiation. Mean preinjection visual acuity was 41 Early Treatment Diabetic Retinopathy Study letters. Mean central retinal thickness was 487.1 μm. Two months after injection, mean visual acuity was 47 Early Treatment Diabetic Retinopathy Study letters. It improved for 3 patients (+4, +9 and, +15 letters) and remained unchanged for 2. Mean central retinal thickness was 331 μm. It decreased for 4 patients (−111, −134, −336, and −187 μm). Two patients underwent a second injection of dexamethasone performed 5 months after the first injection. The gain of visual acuity was +8 and +23 letters with a decrease in central retinal thickness of 158 and 262 μm, respectively. Intraocular pressure increased for 1 patient over a mean follow-up period of 6.4 months.

Conclusion: Intravitreal dexamethasone implant can improve visual acuity in radiation macular edema. The observed beneficial effect lasted up to 5 months.

Five patients with radiation macular edema after proton beam therapy were treated with dexamethasone 0.7-mg intravitreal implant. Visual acuity improved for three patients and remained unchanged for two patients. Mean central retinal thickness decreased for four patients. The beneficial effect lasted up to 5 months.

Department of Ophthalmology, Saint-Roch University Hospital, Nice, France.

Reprint requests: Stéphanie Baillif, MD, PhD, Department of Ophthalmology, Saint Roch Hospital, 5, rue Pierre Dévoluy, Nice, France 06000; e-mail: baillif-gostoli.s@chu-nice.fr

None of the authors have any financial/conflicting interests to disclose.

Minor parts of this study have been presented as a poster at the 2012 European Association for Vision and Eye Research (EVER) congress in Nice, France.

© 2013 by Ophthalmic Communications Society, Inc.