Dexamethasone 0.7‐mg intravitreal implant in patients with radiation macular edema after proton beam therapy for choroidal melanoma: 2‐year results

Abstract

PurposeTo evaluate over a 2‐year period, the efficacy of dexamethasone 0.7‐mg intravitreal implant in patients with radiation macular edema after proton beam therapy for choroidal melanoma.MethodsNine patients’ charts were retrospectively reviewed. The main outcome measures were visual acuity and mean central retinal thickness.ResultsAll patients received a radiation dose of 60 cobalt gray equivalent. Radiation macular edema occurred within a mean time of 41 months after irradiation. Mean preinjection visual acuity was 50 ETDRS letters. Mean central retinal thickness was 461.7 μm. Two months after injection, mean visual acuity was 57 ETDRS letters. It improved for 5 patients (+4, +9, +15, +15, and +19 letters) and remained unchanged for 4. Two months after injection, mean central retinal thickness was 321.6 μm. A complete resolution of radiation macular edema was observed for 7 patients. Four patients underwent several injections of dexamethasone performed 4 to 5 months after the last injection. Intraocular pressure increased for 2 patients over a mean follow‐up period of 24 months. Two patients underwent cataract surgery after the third injection of dexamethasone implant.ConclusionsIntravitreal dexamethasone implant can improve visual acuity in radiation macular edema. The observed beneficial effect lasted up to 5 months.