Editor, A 63-year-old woman was referred to our department with a best-corrected visual acuity (BCVA) of 20/25 in her right eye and 20/20 in her left eye. She presented with a posterior uveal mass of her right eye; this was diagnosed as choroidal melanoma, involving the superonasal quadrant. The tumour sizes were 12.54 mm (base) and 4 mm (height). The patient underwent episcleral plaque radiotherapy with a notched Ruthenium 106 plaque. Fourteen months after plaque treatment, the patient developed early radiation retinopathy involving the fovea – consisting of capillary changes, retinal haemorrhages and retinal exudation (non-proliferative radiation retinopathy) – and was therefore offered sector laser photocoagulation to prevent progression of radiation retinopathy (Finger 1997). Three months later, the patient developed disc neovascularization (proliferative radiation retinopathy) and massive retinal exudation involving the fovea, as evaluated by fundus biomicroscopy, fluorescein angiography (FA) (Fig. 1A) and optical coherence tomography (OCT-3; Humphrey-Zeiss, San Leandro, California, USA) (Fig. 1B); BCVA dropped to 20/200. After discussing adjunctive treatment options and being presented with the option of intravitreal pegaptanib sodium [Macugen®; (OSI) Eyetech and Pfizer Inc., Melville, New York, USA], the patient requested that the treatment be given. Intravitreal pegaptanib sodium 0.3 mg was administered without complication. At the 1-month follow-up, BCVA improved to 20/40; fundus biomicroscopy, FA and OCT revealed almost total resolution of the retinal and macular exudation and partial regression of disc neovascularization. At the time of writing, 6 months after the injection, the patient’s BCVA remained 20/40, with no recurrence of retinal and macular exudation as well as partial regression of disc neovascularization, as evaluated by fundus biomicroscopy, FA (Fig. 1C) and OCT (Fig. 1D). Fluorescein angiography frame (A) and OCT-3 scan (B) of the right eye showing disc neovascularization and massive retinal exudation involving the fovea 3 months after sector scatter laser photocoagulation. Fluorescein angiography frame (C) and OCT-3 scan (D) of the right eye showing partial regression of disc neovascularization and resolution of the retinal and macular exudation 6 months after intravitreal injection of pegaptanib sodium. Closure of blood vessels is the central effect of ionizing radiation. FA after radiation therapy of choroidal melanomas reveals closure of blood vessels within and around the tumour (the tissues surrounding the targeted zone). The histopathology of radiation-induced ischaemic vasculopathy shows the destruction of the endothelial cells and pericytes that maintain blood-vessel walls (Archer et al. 1991). These changes, induced by hypoxia, alter blood flow patterns and produce alternative channels with thickened and fenestrated walls (Archer et al. 1991). Vascular endothelial growth factor (VEGF) is induced by hypoxia and it has been implicated in the development of iris and retinal neovascularization in ischaemic retinopathies. In addition or in association with its role in inducing neovascularization, VEGF may contribute to blood–retinal barrier breakdown in a variety of ocular disorders, and blockage of VEGF signalling may help to reduce some types of macular oedema. Pegaptanib sodium is an anti-VEGF, developed to bind and block the activity of extracellular VEGF (aptamer), specifically the 165-amino-acid isoform (VEGF 165); it is used effectively in the treatment of neovascular age-related macular degeneration (Gragoudas et al. 2004). Given that blockage of VEGF signalling may help to reduce some types of macular oedema (Vinores et al. 1997) and seems to induce short-term reduction of fluorescein leakage from persistent active retinal new vessels (Jorge et al. 2006), we decided to inject 0.3 mg of pegaptanib sodium into the vitreous cavity of our patient. One month after the intravitreal injection of pegaptanib sodium, BCVA improved to 20/40; fundus biomicroscopy, FA and OCT revealed almost total resolution of the retinal and macular exudation and partial regression of disc neovascularization. In addition, there has been no recurrence and no complications from the intravitreal injection of pegaptanib sodium, even at the 6-month follow-up. Similar results have been reported recently using intravitreal bevacizumab, a non-specific anti-VEGF (Finger & Chin 2007). Based on our findings, intravitreal pegaptanib sodium associated with sector scatter laser photocoagulation seems to induce short-term regression of retinal and macular exudation and partial regression of disc neovascularization, with improvement of visual acuity. Further investigations are required to confirm our results. Given that recurrences could be possible and should require additional therapy, we believe that not only more treated cases but also a longer follow-up are needed.