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Intravitreal dexamethasone implant in radiation-induced macular oedema
  1. Luisa Frizziero1,
  2. Raffaele Parrozzani1,
  3. Sara Trainiti1,
  4. Elisabetta Pilotto1,
  5. Giacomo Miglionico2,
  6. Serena Pulze2,
  7. Edoardo Midena1,2
  1. 1 Department of Ophthalmology, University of Padova, Padova, Italy
  2. 2 G.B. Bietti Foundation, IRCCS, Ocular Oncology and Toxicology Research Unit, Roma, Italy
  1. Correspondence to Professor Edoardo Midena, Department of Ophthalmology, University of Padova, 35128 Padova, Italy; edoardo.midena{at}unipd.it

Abstract

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.

  • Inflammation
  • Macula
  • Pathology
  • Retina
  • Treatment Medical
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Footnotes

  • 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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