Aflibercept for Radiation Maculopathy Study

Murray, Timothy G.; Latiff, Azeema; Villegas, Víctor M.; Gold, Aaron S.

doi:10.1016/j.oret.2019.02.009

Cited by 41 publications

(39 citation statements)

References 30 publications

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“…BCVA was stable or improved while few cases revealed loss of more than three lines from their baseline [23]. Similar results were demonstrated by Fallico and Murray that evaluated the efficacy of intravitreal Aflibercept over the 24 months [1,24].…”

Section: Discussionsupporting

confidence: 83%

“…Previous studies have performed only a morphological analysis by SD-OCT showing a retinal structural recovery and a functional stabilization or improvement [1,[23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

“…Radiotherapy is the main treatment for choroidal melanoma and, in particular, ruthenium-106 plaque brachytherapy, although it causes a local irradiation, may determine long-term damage to the retinal vascular network with the appearance of radiation maculopathy (RM), which represents a frequent complication [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography

Cennamo

Montorio

Bernardo

et al. 2020

JCM

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In this prospective study, we investigated the structural and vascular retinal changes at baseline and after Ranibizumab injections at the last follow up to one year in patients affected by Radiation Maculopathy (RM) after plaque brachytheraphy in choroidal melanoma, using Spectral Domain Optical Coherence Tomography (SD-OCT) and OCT Angiography (OCTA). A total of 40 eyes with RM of 40 patients (18 females, 22 males, mean age 51.9 ± 11 years) that underwent ruthenium-106 plaque brachytherapy were included. All patients received one monthly intravitreal injection of Ranibizumab (Pro Re Nata regimen). We analyzed the Foveal Avascular Zone (FAZ) area, the retinal vessel density (VD) of the superficial capillary plexus (SCP) and of the deep capillary plexus (DCP), using OCTA, and we detected the Central Foveal Thickness (CFT) by SD-OCT at baseline and after treatment. At the last follow up, we found a significant improvement of the CFT (p < 0.001) while OCTA parameters revealed no change in VD of the SCP (p = 0.402), DCP (p = 0.282), and FAZ area (p = 0.255), resulting in a stabilization of the visual acuity (p = 0.210) respect to baseline. The absence of functional improvement, despite the anatomical recovery of the macula, could be due to the absence of improvement in FAZ area and in retinal VD after treatment. OCTA parameters could represent predictive biomarkers to anti-vascular endothelial growth factor (anti-VEGF) intravitreal response and to help to better understand the physiopathological mechanisms of the RM.

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Section: Discussionsupporting

confidence: 83%

“…Previous studies have performed only a morphological analysis by SD-OCT showing a retinal structural recovery and a functional stabilization or improvement [1,[23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography

Cennamo

Montorio

Bernardo

et al. 2020

JCM

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“…After radiation, high doses of VEGF are found in the eye [33]. The treatment of anti-VEGF intravitreal injections seems to limit visual loss associated with radiation maculopathy, although this was analysed after a different form of radiation treatment with plaque therapy [28,34]. Shields et al observed a decrease in radiation maculopathy with preservation of visual acuity after prophylactic Bevacizumab every four months [28].…”

Section: Discussionmentioning

confidence: 99%

Local tumour control and radiation side effects for fractionated stereotactic photon beam radiotherapy compared to proton beam radiotherapy in uveal melanoma

Beek¹,

Ramdas²,

Angi

et al. 2021

Radiotherapy and Oncology

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“…Treatment of posterior uveal melanoma has advanced from enucleation to globe-conserving therapies, such as radiation, whenever possible. Radiation treatments, including external beam radiation, plaque brachytherapy, proton beam radiation, helium ion radiotherapy, and Gamma Knife (Elekta, Stockholm, Sweden) radiotherapy, [1][2][3][4][5][6][7][8][9] may result in long-term damage to the retinal vascular endothelial cells, causing radiation maculopathy in more than 75% of eyes undergoing plaque radiotherapy. 10,11 Currently, uveal melanomas are routinely treated with either brachytherapy (iodine-125, palladium-103, or ruthenium-106) or charged-particle radiotherapy (proton or helium beam).…”

Section: Introductionmentioning

confidence: 99%

Aflibercept for Radiation Maculopathy (ARM Study): Year-2 Extension of a Prospective Clinical Study

Murray

Latiff²,

Villegas

et al. 2020

Journal of VitreoRetinal Diseases

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Purpose: This work describes the 2-year results of the Aflibercept for Radiation Maculopathy (ARM) randomized clinical study that evaluated intravitreal vascular endothelial growth factor antagonist therapy in radiation maculopathy delivering aflibercept using a second-year collapsed, every-6-weeks, treat-and-adjust interval. Methods: Forty patients were enrolled in an institutional review board–approved clinical trial and randomly assigned to aflibercept treatment via 1 of 2 regimens: fixed, every-6-week treatment or variable, treat-and-adjust therapy centered around 6 weeks. All patients had a diagnosis of treated uveal melanoma with documented tumor control, and they had visually compromising radiation maculopathy. At conclusion of year 1, the first 30 patients were offered a collapsed single-arm variable of an every-6-weeks treat-and-adjust aflibercept injection schedule for an additional treatment year. Results: Baseline best-corrected visual acuity (BCVA) was 20/63 at ARM study entry 20/62 at the institution of the year-2 extension. At ARM study entry baseline, spectral domain–optical coherence tomography mean central retinal thickness was 432 µm and was 294 µm at the same institution. At the 2-year study’s conclusion, 76.7% (23 of 30) of eyes were better than 20/50, and only 6.7% (2 of 30) ended with a BCVA below 20/200. Final mean BCVA was 20/62 and final mean spectral domain–optical coherence tomography central retinal thickness was 286 µm, but as in year 1, this reduction in number of injections was not statistically significant. Conclusions: Aflibercept is effective in treating radiation maculopathy with maintained visual acuity at 2 years but continues to require an ongoing treatment approach to stabilize radiation maculopathy.

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Aflibercept for Radiation Maculopathy Study

Cited by 41 publications

References 30 publications

Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography

Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography

Local tumour control and radiation side effects for fractionated stereotactic photon beam radiotherapy compared to proton beam radiotherapy in uveal melanoma

Aflibercept for Radiation Maculopathy (ARM Study): Year-2 Extension of a Prospective Clinical Study

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