Double dose of anti-VEGF may reduce macular edema after irradiation for uveal melanoma
PHILADELPHIA — Double doses of intravitreal bevacizumab may reduce macular thickness and improve best corrected visual acuity in patients with post-radiation cystoid macular edema that does not respond to standard dosing, according to a study presented here.
The 2.5 mg double dose may not be a treatment option for patients whose macular edema worsened following the standard dose of 1.25 mg, Arman Mashayekhi, MD, said at the Wills Eye Annual Conference.
“[In] patients who got worse with the standard dose, none improved with the double dose either,” Mashayekhi said. “That may help us in selecting our patients. In fact, if we delete this group from the study, our success rates will improve from 33% to 41%.”
The study included 21 adults with uveal melanoma treated with iodine-125 plaque radiotherapy and macular edema that did not resolve after standard dosing with 1.25 mg intravitreal Avastin (bevacizumab, Genentech). The double-dose injections were given every 4 weeks up to 6 months. Macular thickness remained stable in nine patients, worsened in five and improved in seven after receiving double doses of bevacizumab.
Mean macular thickness decreased from 374 µm to 303 µm in the improved group and from 457 µm to 445 µm in the stable group. In patients whose condition worsened, macular thickness increased from 376 µm to 498 µm.
Vision also improved in patients with reduced macular thickness and in some patients whose macular thickness remained stable, Mashayekhi said.
Disclosure: Mashayekhi has no relevant financial disclosures.