Anti-vascular endothelial growth factor bevacizumab (Avastin) for radiation retinopathy

Objective: To evaluate intravitreal bevacizumab for radiation retinopathy. Methods: After plaque radiation therapy, 6 patients developed radiation retinopathy (retinal edema, hemorrhages, microangiopathy, and neovascularization). Intravitreal bevacizumab (1.25 mg in 0.05 mL) was periodically injected (every 6-8 weeks). Ophthalmic evaluations included visual acuity, ophthalmic examination, fundus photography, fluorescein angiography, and optical coherence tomography/scanning laser ophthalmoscopy (OCT/SLO) imaging. Results: No bevacizumab-related ocular or systemic adverse effects have occurred within the first 8 months of therapy. Progressive reductions in retinal hemorrhages, exudates, cotton-wool spots, and microangiopathy were documented by photography, angiography, and OCT/SLO imaging. Decreased macular edema was the most common finding. Improvement or stabilization of visual acuity was noted in all cases. Conclusions: Intravitreal bevacizumab was tolerated, improved or maintained vision, and reduced hemorrhage and retinal edema (angiographic leakage). This study should lead to additional and longer-term studies of humanized monoclonal anti-vascular endothelial growth factor antibody therapy for radiation retinopathy.