Retinal Microvascular Changes in Uveal Melanoma Following Conbercept Injection After Plaque Radiotherapy as Detected by Optical Coherence Tomography Angiography

Abstract

Purpose: To investigate macular microvascular characteristics imaged by optical coherence tomography angiography in patients with uveal melanoma following conbercept injections after plaque radiotherapy. Methods: Prospective comparative analysis comprising 15 patients with uveal melanoma with conbercept injections and 30 patients without conbercept injections after plaque radiotherapy by optical coherence tomography angiography. The conbercept group received intravitreal conbercept injections at the time of plaque removal, 1 month, 3 months, 6 months , 9 months and 12 months after plaque removal (total, 6 injections). The control group had no intravitreal conbercept injection. Results: After initiation of conbercept injections, superficial retinal vascular density in the whole image and parafoveal region were significantly higher at 6 months, whereas there was no significant difference at 9 months and 12 months. In analysis of variance analysis, superficial retinal vascular density in the whole image remained stable after conbercept injections (P = 0.069), whereas the superficial retinal vascular density decreased significantly after plaque radiotherapy in the control group (P = 0.011). In multivariable linear regression, a higher superficial retinal vascular density in the whole image region at 6 months was significantly associated with intravitreal conbercept injection (P = 0.018), wider tumor base (P = 0.026), and thinner tumor thickness (P = 0.04). Conclusion: Optical coherence tomography angiography can provide a quantitative evaluation of early retinal microvascular changes after radiotherapy. Intravitreal conbercept treatment could partly relieve the retinal vascular damage in response to radiation therapy at early stage in patients with uveal melanoma; however, it may not be able to provide long-term positive functional outcomes.

Ocular Delivery of Therapeutic Agents by Cell-Penetrating Peptides

“…However, worldwide Phase III clinical trials PANDA-1 and PANDA-2 (NCT03630952 and NCT03577899) were terminated because the desired primary endpoint was not met. Conbercept was also tested for uveal melanoma after plaque radiotherapy and showed partly relieved retinal vascular damage in response to radiation therapy, but it may not provide long-term positive functional outcomes [ 137 ].…”

Imaging of Uveal Melanoma—Current Standard and Methods in Development

“…Jing Yan Yang et al [102] investigated macular microvascular characteristics imaged with optical coherence tomography angiography (OCTA) in uveal melanoma (UM). Patients were treated with conbercept injections preceded by plaque radiotherapy.…”

Importance of Optical Coherence Tomography and Optical Coherence Tomography Angiography in the Imaging and Differentiation of Choroidal Melanoma: A Review

“…OCTA is the main instrument for the early detection and monitoring of subclinical forms of radiation maculopathy and identifying patients who might benefit from the anti-VERGF injection. Evaluation of anti-VEGF treatment outcomes with conbercept has demonstrated an increase in sCVD [ 87 ]. The underlying mechanism of the increase in blood-flow density after administering the anti-VEGF agent is yet to be understood.…”

“…The timing of anti-VEGF administration is important, as this agent should be given after completing radiotherapy, when the tumor remains inactive. This prevents a potential decrease in the radiosensitivity of the tumor, associated with ischemia [ 87 ].…”