Intravitreal Bevacizumab at 4-Month Intervals for Prevention of Macular Edema after Plaque Radiotherapy of Uveal Melanoma
| Autor: | Josep Badal, Carol L. Shields, Sanket U. Shah, Juan C. Iturralde, Jerry A. Shields, Arman Mashayekhi, Saad Al-Dahmash, Carlos Bianciotto, Emil Anthony T. Say |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Uveal Neoplasms Vascular Endothelial Growth Factor A medicine.medical_specialty Visual acuity Adolescent genetic structures Bevacizumab medicine.medical_treatment Brachytherapy Vision Disorders Visual Acuity Angiogenesis Inhibitors Antibodies Monoclonal Humanized Macular Edema Retina Young Adult Ophthalmology Humans Medicine Cumulative incidence Fluorescein Angiography Radiation Injuries Melanoma Macular edema Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Plaque radiotherapy Retrospective cohort study Middle Aged Fluorescein angiography medicine.disease eye diseases Treatment Outcome Intravitreal Injections Maculopathy Female sense organs medicine.symptom business Tomography Optical Coherence medicine.drug |
| Zdroj: | Ophthalmology. 121:269-275 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2013.08.039 |
| Popis: | Purpose To evaluate the efficacy of intravitreal bevacizumab for prevention of macular edema after plaque radiotherapy of uveal melanoma. Design Retrospective, single-center, nonrandomized, interventional comparative study. Participants Patients with uveal melanoma treated with plaque radiotherapy were divided into 2 groups: a bevacizumab group and a control group. Intervention The bevacizumab group received intravitreal bevacizumab injection at the time of plaque removal and every 4 months thereafter for 2 years (total, 7 injections). The control group had no intravitreal bevacizumab injection. Both groups had periodic follow-up with ophthalmoscopy and optical coherence tomography (OCT). Main Outcome Measures Development of OCT-evident macular edema. Results There were 292 patients in the bevacizumab group and 126 in the control group. The median foveolar radiation dose was 4292 cGy (bevacizumab) and 4038 cGy (control; P = 0.327). The cumulative incidence of OCT-evident macular edema over 2 years (bevacizumab group vs. control group) was 26% versus 40% ( P = 0.004), respectively; that for clinically evident radiation maculopathy was 16% versus 31% ( P = 0.001), respectively; that for moderate vision loss was 33% versus 57% ( P P = 0.004), respectively. There was no statistically significant difference in clinically evident radiation papillopathy ( P = 0.422). Kaplan-Meier estimates at 2 years showed statistically significantly reduced rates of OCT-evident macular edema ( P = 0.045) and clinically evident radiation maculopathy ( P = 0.040) in the bevacizumab group compared with controls. Conclusions Patients receiving intravitreal bevacizumab injection every 4 months after plaque radiotherapy for uveal melanoma demonstrated OCT-evident macular edema, clinically evident radiation maculopathy, moderate vision loss, and poor visual acuity less frequently over a period of 2 years than patients not receiving the injections. |
| Databáze: | OpenAIRE |
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