Aims To evaluate the efficacy and duration of activity of a single intravitreal dexamethasone implant in patients affected by radiation maculopathy.
Methods Thirteen consecutive eyes of 13 patients affected by radiation maculopathy secondary to eye irradiation for a primary uveal melanoma (Iodine-125 brachytherapy) and treated with a single intravitreal 0.7 mg dexamethasone implant were retrospectively evaluated. Each patient underwent full ophthalmological examination, including fluorescein angiography and spectral domain optical coherence tomography (SD-OCT), even in en-face modality. Follow-up was performed monthly over a 6-month period.
Results At preinjection visit, the median central subfield thickness (CST) by SD-OCT was 407 µm (IQR, 357–524 µm) and the median best-corrected visual acuity (BCVA) was 61 ETDRS score (IQR, 54–67). The median gain of ETDRS letter at 1 month was 6.5 (IQR, 4–15) (p<0.01). The median CST showed a reduction of 120 µm (IQR, 62–134) (p<0.01). Further CST reduction was reported at 2 months' follow-up, with CST stabilisation at 3 months and maintenance of BCVA. At 4, 5 and 6 months' follow-up, all patients presented progressive retinal thickening (p<0.01) and BCVA reduction (p<0.01). No side effects were documented.
Conclusion Intravitreal dexamethasone implant reduces macular oedema secondary to radiation maculopathy and also improved visual acuity in a consistent proportion of patients. Signs of macular oedema recurrence may be detected at a median of 4 months after injection.
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Contributors LF, RP and EM: study conception, design, interpretation of data, drafting and revising, final approval and agreement to be accountable for all aspects of the work. ST, EP, GM and SP: data acquisition/analysis/interpretation, drafting and revising of work, final approval and agreement to be accountable for all aspects of the work.
Funding The contribution of the Fondazione Bietti in this paper was supported by the Ministry of Health and Fondazione Roma.
Competing interests None declared.
Ethics approval Institutional review board.
Provenance and peer review Not commissioned; externally peer reviewed.
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