Outcomes of systemic bevacizumab in radiation-induced optic neuropathy, case series

Abstract

Purpose:Optic neuropathy is a rare, delayed complication after radiation with no universally accepted treatment modality. We report the outcomes of 6 patients with radiation-induced optic neuropathy (RION) who were treated with systemic bevacizumab.Methods: This is a retrospective series of 6 cases of RION, treated with intravenous (IV) bevacizumab. "Improved" or "worse" visual outcomes were de ned as a change in best corrected visual acuity of ≥3 Snellen lines. Otherwise, the visual outcome was noted as "stable".Results: In our series, RION was diagnosed 8 to 36 months after radiotherapy. IV bevacizumab was initiated as treatment within 6 weeks of the onset of visual symptoms in 3 cases and after 3 months in the other cases. Although no improvement in visual function was observed, stabilization of vision was noted in 4 of the 6 cases. In the other 2 cases, the level of vision declined from counting ngers to no light perception. In 2 cases, bevacizumab treatment was discontinued prior to completion of the planned course due to renal stone formation or worsening of renal disease. One patient developed ischemic stroke 4 months after bevacizumab completion.Conclusion: Systemic bevacizumab may stabilize vision in some patients with RION; however, the risks and potential bene ts of using IV bevacizumab should be considered in each individual case.

Neurologic Complications in Adult Cancer Survivorship

“…54 OCTA is a noninvasive imaging technique to help reveal the vascularity of the retina and optic nerve head. Vitreal injections of bevacizumab have been used 55 but, unfortunately, recovery is rare. Steroids and anticoagulants are not effective.…”