Posters

Intravitreal dexamethasone implant in late onset radiation maculopathy secondary to plaque brachytherapy in choroidal melanoma refractory to anti-VEGF therapy: A case report

Poster Details

First Author: M.Dell'Acqua ITALY

Co Author(s):    G. Trabucchi                             

Abstract Details



Purpose:

To evaluate the efficacy of intravitreal dexamethasone implant (0.7 mg) in late onset radiation maculopathy refractory to anti-VEGF therapy.

Setting:

Department of Ophthalmology, ASST-Ovest Milanese, Legnano, Italy

Methods:

the patient received intravitreal dexamethasone implant (0.7 mg) after non-responding previous treatments with 4 injections of intravitreal Aflibercept. Visual acuity and foveal thickness using macular optical coherence tomography (SD-OCT) were evaluated.

Results:

A 56-year-old man treated with brachytherapy for choroidal melanoma (total dose: 60 CGE) developed 8 years later radiation retinopathy with haemorrhages, telangiectasic vessels, hard exudates complicated by cystoid macular edema. The best corrected visual acuity (BCVA) was 20/20 quickly worsening until 20/80. SD-OCT showed cystoid macular edema with increase of macular thickness. After 4 injections of intravitreal Aflibercept without improvement in visual acuity and reduction of macular thickness, the patient was treated with intravitreal dexamethasone implant (0.7 mg). After three months we observed a reduction in macular thickness; the BCVA was 20/70. An elevation of intraocular pressure was measured and treated by topical antiglaucomatous therapy.

Conclusions:

Intravitreal dexamethasone implant could represent a useful treatment for radiation maculopathy refractory to other therapies with a decrease in macular thickness and moderate improvement in visual acuity. Developing better therapeutic as well as preventive treatment strategies remains the aim of the management of these patients.

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