Journal
SURVEY OF OPHTHALMOLOGY
Volume 66, Issue 3, Pages 441-460Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.survophthal.2020.08.007
Keywords
radiation maculopathy; radiation-induced macular edema; radiation retinopathy; radiotherapy; uveal melanoma
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Radiation maculopathy and radiation-induced macular edema are common complications after radiotherapy, especially for uveal melanoma. Current management typically involves intravitreal anti vascular endothelial growth factor injections.
Radiation maculopathy and radiation-induced macular edema are common, sight threatening complications after radiotherapy, especially that used for uveal melanoma. While many treatment and preventive strategies have been proposed, management of these conditions is still challenging. Initially, treatments were based on the use of retinal laser, but the outcomes were poor. Subsequently, management has shifted toward injection of intravitreal antivascular endothelial growth factor or corticosteroids. We reviewed current clinical evidence, which mostly relies on small sample-sized and retrospective studies, for the management of radiation maculopathy and, in particular, radiation induced macular edema. At present, the first-line approach is usually intravitreal anti vascular endothelial growth factor. Intravitreal dexamethasone implantation may be an option for those with suboptimal response or contraindications to antivascular endothelial growth factor agents. Possible preventive treatments that require future study are intravitreal bevacizumab and ranibizumab, peripheral laser photocoagulation, and subtenon triamcinolone acetonide. (c) 2020 Elsevier Inc. All rights reserved.
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