Radiation maculopathy
Reviewed by Jonathan Chan

This is a retrospective non-randomised study of 13 consecutive eyes of 13 patients affected by radiation maculopathy secondary to eye irradiation for primary uveal melanoma (Iodine-125 brachytherapy). All patients were treated with a single intravitreal 0.7mg dexamethasone implant and full work-up was performed to all patients including fluorescein angiogram and OCT imaging. The follow-up period was over six months’ duration. The preoperative median central subfield thickness (CST) by spectral domain OCT was 407um and the median CST reduction of 120um postoperatively with further reduction at two months and stabilisation at three months. At four, five and six months, all patients showed progressive retinal thickening (p<0.01). The preoperative median best-corrected visual acuity (BCVA) was 61 EDTRS score and the median gain of EDTRS letter at one month was 6.5 but at four, five and six months, all patients showed BCVA reduction (p<0.01). No side-effects were noted. The authors conclude that the intravitreal dexamethasone implant is a reasonable option as a minimally invasive treatment with a favourable safety profile and less necessity of retreatment compared with other options. An early retreatment decision point at four months at the beginning of the macular oedema relapse was suggested by the study group.

Intravitreal dexamethasone implant in radiation induced macular oedema.
Frizziero L, Parrozzani R, Trainiti S, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2017;101:1699-1703.