INTRAVITREAL DEXAMETHASONE 0.7-MG IMPLANT FOR RADIATION MACULAR EDEMA AFTER PROTON BEAM THERAPY FOR CHOROIDAL MELANOMA

Purpose: To evaluate the efficacy of dexamethasone 0.7-mg intravitreal implant in patients with radiation macular edema after proton beam therapy for choroidal melanoma. Methods: Five patients' charts were retrospectively reviewed. The main outcome measures were visual acuity and mean central retinal thickness. Results: All patients received a radiation dose of 60 cobalt gray equivalent. Radiation macular edema occurred within a mean time of 26 months after irradiation. Mean preinjection visual acuity was 41 Early Treatment Diabetic Retinopathy Study letters. Mean central retinal thickness was 487.1 mu m. Two months after injection, mean visual acuity was 47 Early Treatment Diabetic Retinopathy Study letters. It improved for 3 patients (+4, +9 and, +15 letters) and remained unchanged for 2. Mean central retinal thickness was 331 mu m. It decreased for 4 patients (-111, -134, -336, and -187 mu m). Two patients underwent a second injection of dexamethasone performed 5 months after the first injection. The gain of visual acuity was +8 and +23 letters with a decrease in central retinal thickness of 158 and 262 mu m, respectively. Intraocular pressure increased for 1 patient over a mean follow-up period of 6.4 months. Conclusion: Intravitreal dexamethasone implant can improve visual acuity in radiation macular edema. The observed beneficial effect lasted up to 5 months.