Tags

Type your tag names separated by a space and hit enter

Radiation-Induced Optic Neuropathy: Observation versus Intravitreal Treatment: Can Visual Acuity Be Maintained by Intravitreal Treatment?
Am J Ophthalmol. 2019 12; 208:289-294.AJ

Abstract

PURPOSE

To compare intravitreal therapy with the natural course of radiation optic neuropathy after primary proton beam therapy for choroidal melanoma with respect to long-term visual acuity and development of optic atrophy.

DESIGN

Retrospective comparative case series.

METHODS

Inclusion criteria: patients treated with primary proton beam therapy for choroidal melanoma with a minimum follow-up of 24 months after the occurrence of radiation optic neuropathy and optic disc imaging during follow-up.

EXCLUSION CRITERIA

pathologic condition of the optic disc before irradiation and intravitreal therapy to treat cystoid macular edema not originating from the optic disc.

RESULTS

Of 93 patients, 48 were observed only after radiation optic neuropathy, and 45 were treated with intravitreal therapy (triamcinolone, bevacizumab, and/or dexamethasone). Median follow-up was 55 months (29-187 months); median interval between onset of radiation optic neuropathy and the last patient visit was 34 months (24-125 months). Of 48 observed patients, 41 (85.4%) developed an optic atrophy after a median of 14 months (3-86 months) after radiation optic neuropathy; and of 45 intravitreally treated patients, 34 (75.5%) presented with an optic atrophy after a median of 12.5 months (1-55 months) following optic neuropathy, indicating no statistically significant differences between the groups. Comparing the change in visual acuity from occurrence of optic neuropathy to final visual acuity, no statistically significant differences were found between either group (P = 0.579).

CONCLUSIONS

Patients treated with intravitreal therapy for radiation optic neuropathy showed no statistically significant differences related to visual acuity or optic atrophy development from patients who underwent only observation.

Authors+Show Affiliations

Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany.Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany.Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Protonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Berlin, Germany.Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany.Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany.Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany.Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany.Charité-Universitätsmedizin Berlin, Corporate Member of Free Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Ophthalmology, Campus Benjamin Franklin, Berlin, Germany. Electronic address: ira.seibel@charite.de.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31323201

Citation

Eckstein, Daniela, et al. "Radiation-Induced Optic Neuropathy: Observation Versus Intravitreal Treatment: Can Visual Acuity Be Maintained By Intravitreal Treatment?" American Journal of Ophthalmology, vol. 208, 2019, pp. 289-294.
Eckstein D, Riechardt AI, Heufelder J, et al. Radiation-Induced Optic Neuropathy: Observation versus Intravitreal Treatment: Can Visual Acuity Be Maintained by Intravitreal Treatment? Am J Ophthalmol. 2019;208:289-294.
Eckstein, D., Riechardt, A. I., Heufelder, J., Zeitz, O., Böker, A., Brockmann, C., Joussen, A. M., & Seibel, I. (2019). Radiation-Induced Optic Neuropathy: Observation versus Intravitreal Treatment: Can Visual Acuity Be Maintained by Intravitreal Treatment? American Journal of Ophthalmology, 208, 289-294. https://doi.org/10.1016/j.ajo.2019.07.004
Eckstein D, et al. Radiation-Induced Optic Neuropathy: Observation Versus Intravitreal Treatment: Can Visual Acuity Be Maintained By Intravitreal Treatment. Am J Ophthalmol. 2019;208:289-294. PubMed PMID: 31323201.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiation-Induced Optic Neuropathy: Observation versus Intravitreal Treatment: Can Visual Acuity Be Maintained by Intravitreal Treatment? AU - Eckstein,Daniela, AU - Riechardt,Aline I, AU - Heufelder,Jens, AU - Zeitz,Oliver, AU - Böker,Alexander, AU - Brockmann,Claudia, AU - Joussen,Antonia M, AU - Seibel,Ira, Y1 - 2019/07/16/ PY - 2019/03/18/received PY - 2019/06/22/revised PY - 2019/07/11/accepted PY - 2019/7/20/pubmed PY - 2020/3/28/medline PY - 2019/7/20/entrez SP - 289 EP - 294 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 208 N2 - PURPOSE: To compare intravitreal therapy with the natural course of radiation optic neuropathy after primary proton beam therapy for choroidal melanoma with respect to long-term visual acuity and development of optic atrophy. DESIGN: Retrospective comparative case series. METHODS: Inclusion criteria: patients treated with primary proton beam therapy for choroidal melanoma with a minimum follow-up of 24 months after the occurrence of radiation optic neuropathy and optic disc imaging during follow-up. EXCLUSION CRITERIA: pathologic condition of the optic disc before irradiation and intravitreal therapy to treat cystoid macular edema not originating from the optic disc. RESULTS: Of 93 patients, 48 were observed only after radiation optic neuropathy, and 45 were treated with intravitreal therapy (triamcinolone, bevacizumab, and/or dexamethasone). Median follow-up was 55 months (29-187 months); median interval between onset of radiation optic neuropathy and the last patient visit was 34 months (24-125 months). Of 48 observed patients, 41 (85.4%) developed an optic atrophy after a median of 14 months (3-86 months) after radiation optic neuropathy; and of 45 intravitreally treated patients, 34 (75.5%) presented with an optic atrophy after a median of 12.5 months (1-55 months) following optic neuropathy, indicating no statistically significant differences between the groups. Comparing the change in visual acuity from occurrence of optic neuropathy to final visual acuity, no statistically significant differences were found between either group (P = 0.579). CONCLUSIONS: Patients treated with intravitreal therapy for radiation optic neuropathy showed no statistically significant differences related to visual acuity or optic atrophy development from patients who underwent only observation. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/31323201/Radiation-induced_optic_neuropathy_-_observation_versus_intravitreal_treatment L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(19)30327-7 DB - PRIME DP - Unbound Medicine ER -