Treatment of radiation retinopathy following plaque brachytherapy for choroidal melanoma

Abstract

Radiation retinopathy and maculopathy are predictable complications resulting from exposure to any source of radiation, including external beam and plaque brachytherapy. Most choroidal melanomas are currently treated with plaque brachytherapy. However, the ensuing complications frequently compromise posttreatment vision. The purpose of this review is to discuss recent studies on the management of radiation retinopathy and maculopathy. Intravitreal bevacizumab, intravitreal triamcinolone and laser photocoagulation appear to transiently decrease macular edema, although improvements in visual acuity are limited. In successful studies, recurrent treatments were needed to sustain the effects. Case studies of photodynamic therapy, oral pentoxyphylline and hyperbaric oxygen treatment describe positive results, but further studies are required. One study suggests that laser photocoagulation may be useful in prophylactically treating radiation retinopathy. Currently, there are no proven treatments for radiation retinopathy or maculopathy. The current treatment methods require frequent administration with variable improvement in visual acuity.