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Treatment of macular oedema following proton beam therapy for choroidal melanoma with dexamethasone 700µg intravitreal implant
Author(s) -
BAILLIF S,
GASTAUD P,
CAUJOLLE JP
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.s012.x
Subject(s) - medicine , dexamethasone , macular edema , ophthalmology , visual acuity , implant , edema , choroidal melanoma , complication , intraocular pressure , surgery , melanoma , cancer research
Purpose To report the treatment of radiation macular edema following proton beam therapy for choroidal melanoma with dexamethasone 700µg intravitreal implant. Methods Retrospective cases report Results Five patients were treated with a single injection of intravitreal dexamethasone 700 µg. These patients presented with an uveal melanoma (mean thickness: 4.44 mm, mean highest diameter: 11.14mm) located at 2.58mm (range 0 to 3.5mm) from the macula. Patients were treated with proton beam irradiation (60 Gy cobalt relative biological effectiveness in 4 fractions) 26.75 months (range 16‐43 months) before the occurrence of radiation macular edema. The intravitreal injection of dexamethasone700 µg was performed 5.5 months (1‐14) after the diagnosis of macular edema. Best corrected visual acuity improved for 4 patients (5; 7; 9 and 10 letters), and remained unchanged for 1 patient, over a 5 months follow‐up period. Central retinal thickness decreased for 3 patients (231; 151 and 97 µm) and remained unchanged for 2 patients. Intraocular pressure increased for 1 patient (IOP>25 mmHg at month 3). No other ocular or systemic side effects were noted. Conclusion Radiation macular edema is a common vision threatening complication following proton beam therapy. The available therapeutic options are limited. Intravitreal injections of dexamethasone implant can be of benefit in selected cases.