Prophylactic use of bevacizumab to avoid anterior segment neovascularization following proton therapy for uveal melanoma.


Autoria(s): Mantel, Irmela; Schalenbourg, Ann; Bergin, Ciara; Petrovic, Aleksandra; Weber, Damien Charles; Zografos, Leonidas
Data(s)

01/10/2014

Resumo

PURPOSE To investigate whether the prophylactic use of bevacizumab reduces the rate of rubeosis after proton therapy for uveal melanoma and improves the possibility to treat ischemic, reapplicated retina with laser photocoagulation. DESIGN Comparative retrospective case series. METHODS Uveal melanoma patients with ischemic retinal detachment and treated with proton therapy were included in this institutional study. Twenty-four eyes received prophylactic intravitreal bevacizumab injections and were compared with a control group of 44 eyes without bevacizumab treatment. Bevacizumab injections were performed at the time of tantalum clip insertion and were repeated every 2 months during 6 months, and every 3 months thereafter. Ultra-widefield angiography allowed determination of the extent of retinal ischemia, which was treated with laser photocoagulation after retinal reapplication. Main outcome measures were the time to rubeosis, the time to retinal reattachment, and the time to laser photocoagulation of ischemic retina. RESULTS Baseline characteristics were balanced between the groups, except for thicker tumors and larger retinal detachments in the bevacizumab group, potentially to the disadvantage of the study group. Nevertheless, bevacizumab prophylaxis significantly reduced the rate of iris rubeosis from 36% to 4% (log-rank test P = .02) and tended to shorten the time to retinal reapplication until laser photocoagulation of the nonperfusion areas could be performed. CONCLUSIONS Prophylactic intravitreal bevacizumab in patients treated with proton therapy for uveal melanoma with ischemic retinal detachment prevented anterior segment neovascularization, until laser photocoagulation to the reapplied retina could be performed.

Formato

application/pdf

Identificador

http://boris.unibe.ch/61605/1/1-s2.0-S0002939414003936-main.pdf

Mantel, Irmela; Schalenbourg, Ann; Bergin, Ciara; Petrovic, Aleksandra; Weber, Damien Charles; Zografos, Leonidas (2014). Prophylactic use of bevacizumab to avoid anterior segment neovascularization following proton therapy for uveal melanoma. American journal of ophthalmology, 158(4), 693-701.e2. Elsevier Science 10.1016/j.ajo.2014.07.002 <http://dx.doi.org/10.1016/j.ajo.2014.07.002>

doi:10.7892/boris.61605

info:doi:10.1016/j.ajo.2014.07.002

info:pmid:25034116

urn:issn:0002-9394

Idioma(s)

eng

Publicador

Elsevier Science

Relação

http://boris.unibe.ch/61605/

Direitos

info:eu-repo/semantics/restrictedAccess

Fonte

Mantel, Irmela; Schalenbourg, Ann; Bergin, Ciara; Petrovic, Aleksandra; Weber, Damien Charles; Zografos, Leonidas (2014). Prophylactic use of bevacizumab to avoid anterior segment neovascularization following proton therapy for uveal melanoma. American journal of ophthalmology, 158(4), 693-701.e2. Elsevier Science 10.1016/j.ajo.2014.07.002 <http://dx.doi.org/10.1016/j.ajo.2014.07.002>

Palavras-Chave #610 Medicine & health
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/publishedVersion

PeerReviewed