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Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Medical Treatments

Background:

  • Radiation maculopathy is a complication of ocular radiotherapy, often leading to vision loss.
  • Intravitreal vascular endothelial growth factor (VEGF) antagonists are used to manage radiation maculopathy.
  • Evaluating different dosing strategies for VEGF antagonists is crucial for optimizing treatment outcomes.

Purpose of the Study:

  • To compare two intravitreal aflibercept treatment schedules for radiation maculopathy.
  • To assess a fixed 6-week interval versus a treat-and-adjust interval for aflibercept therapy.
  • To determine the efficacy of aflibercept in preserving visual acuity and retinal structure.

Main Methods:

  • A randomized, prospective clinical trial involving 40 patients with radiation maculopathy secondary to uveal melanoma.
  • Patients were assigned to either a fixed every-6-weeks aflibercept regimen or a treat-and-adjust regimen.
  • Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) central retinal thickness were evaluated at 1 year.

Main Results:

  • BCVA was maintained from baseline (20/63) to 1 year (20/62).
  • Mean central retinal thickness decreased significantly from 432 μm to 294 μm (P < 0.02).
  • 42.5% of patients achieved BCVA of 20/50 or better, with only 5% having BCVA worse than 20/200 at 1 year. No significant difference in injection frequency between groups.

Conclusions:

  • Intravitreal aflibercept effectively limits vision loss in radiation maculopathy.
  • No significant difference was observed between fixed 6-week and treat-and-adjust intervals, suggesting a consistent need for treatment.
  • Aflibercept demonstrates efficacy in managing radiation maculopathy, necessitating an ongoing treatment approach.