Carol L. Shields
PHILADELPHIA — Ocular melanoma patients who received prophylactic bevacizumab with plaque radiotherapy experienced significantly better visual acuity outcomes than control patients who did not receive bevacizumab, according to a speaker here.
“The complications of plaque radiotherapy are numerous, including retinopathy, papillopathy, choroidopathy and others,” Carol L. Shields, MD, said at the Wills Eye Conference. “So, how can we prevent or maybe eliminate these complications?”
Previous studies showed that one injection of an anti-VEGF agent did not change visual outcomes for plaque radiotherapy recipients; however, Shields and her team asked if continuous bevacizumab treatment could help in 3 years.
A study of 1,131 patients found a significant difference over that time period.
Ocular melanoma patients who received prophylactic bevacizumab with plaque radiotherapy experienced significantly better visual acuity outcomes than control patients who did not receive bevacizumab.
Patients in the bevacizumab group experienced significantly less cystoid macular edema, radiation maculopathy and radiation papillopathy.
“Here is the most amazing outcome: We found significant preservation of visual acuity in the bevacizumab group compared to the control group,” Shields said.
After the first year, patients in the treatment group had a mean visual acuity of 20/40 compared with 20/60 in the control group. In the second year, visual acuity was 20/50 vs. 20/100, and in the third year, 20/60 vs. 20/200. In the study’s fourth year, when patients were no longer receiving bevacizumab injections, those in the treatment group had visual acuity of 20/70 compared with counting fingers in the control group.
“We’re just beginning this investigation of bevacizumab,” Shields said. “We are wondering if we should actually continue [bevacizumab injections] at a greater interval for the long run.” – by Rebecca L. Forand
Shields C. Prophylactic bevacizumab following plaque radiotherapy for uveal melanoma in 1,131 patients. Presented at: Wills Eye Conference; March 5-7, 2020; Philadelphia.
Disclosure: Shields reports no relevant financial disclosures.