Use of dexamethasone 0.7mg intravitreal implant in radiation macular edema

Abstract

AbstractPurpose To evaluate the efficacy and safety over one year of follow‐up of dexamethasone 0.7mg intravitreal implant in patients with radiation macular edema (ME) after proton beam therapy for choroidal melanomaMethods Five patients’ charts were retrospectively reviewed.Results All patients received a radiation dose of 60 cobalt Gray equivalent. Radiation ME occurred within a mean time of 26 months after irradiation. Mean preinjection VA was 41 ETDRS letters. Two months after injection, mean VA was 47 ETDRS letters. It improved for 3 patients (+4; +9 and +15 letters) and remained unchanged for 2. Mean CRT was 331 µm. Over one year of follow‐up, two patients underwent 2 injections of dexamethasone performed 5 months after the first injection. The gain of VA was +8 and +23 letters with a decrease in CRT of 158 and 262 µm respectively. Intraocular pressure increased for 1 patient. One patient was enucleated due to a local recurrence of his choroidal melanoma. Another patient presented with a radiation neuropathy with a great loss of visual acuity.Conclusion Intravitreal dexamethasone implant can improve VA in radiation ME. Its beneficial effect lasted up to 5 months. Other causes of vision loss may jeopardize this beneficial effect.