Intravitreal Bevacizumab for Radiation-Induced Cystoid Macular Oedema in Patients with Nasopharyngeal Carcinoma: A Clinical Series

• Published in: Ophthalmologica (Basel) Vol. 229; no. 4; pp. 208 - 211
• Main Authors: Subrayan, Visvaraja, Khaw, Keat Ween, Peyman, Mohammadreza, Koay, Adrian Choon Aun, Tajunisah, Iqbal
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2013
• Subjects: Aged; Angiogenesis Inhibitors - administration & dosage; Antibodies, Monoclonal, Humanized - administration & dosage; Bevacizumab; Carcinoma; Female; Fluorescein Angiography; Fundus Oculi; Humans; Intravitreal Injections; Macula Lutea - pathology; Macula Lutea - radiation effects; Macular Edema - drug therapy; Macular Edema - etiology; Macular Edema - pathology; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms - radiotherapy; Original Paper; Radiation Injuries - complications; Radiation Injuries - drug therapy; Radiation Injuries - pathology; Retrospective Studies; Time Factors; Tomography, Optical Coherence; Treatment Outcome; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity; Nasopharyngeal carcinoma; Radiation maculopathy; Anti-vascular endothelial growth factor; Cystoid macular oedema
• ISSN: 0030-3755; 1423-0267
• DOI: 10.1159/000348630

Aims: To evaluate the outcome of intravitreal bevacizumab in the treatment of radiation-induced cystoid macular oedema among patients who underwent external beam radiotherapy for nasopharyngeal carcinoma. Methods: Five patients were recruited. The length of time from the last external beam radiation therapy to presentation ranged from 12 months to 15 years. Intravitreal bevacizumab (1.25 mg/0.05 ml) was given and repeated monthly injections were administered until best corrected visual acuity (BCVA) improved to 6/9 or until 3 further injections did not show further improvement in BCVA. BCVA was measured and fundus photography, optical coherence tomography (OCT) and fluorescein angiography were performed at baseline. BCVA and OCT were recorded at each monthly visit. The duration of follow-up ranged from 6 months to 2 years. Results: Five patients (7 eyes) were recruited. At the final visit, 3 eyes (71.4%) showed reduction in the central subfield thickness (CST; mean reduction of 17.6%, range 9-149 µm) with improvement in BCVA, whilst 2 eyes worsened in terms of CST and final BCVA. Another 2 eyes remained altered in BCVA despite slight improvement in CST. Conclusion: The use of intravitreal bevacizumab in this group of patients showed variable response in terms of CST and BCVA outcome but remains a viable option to treat this challenging condition.