Combined Laser Photocoagulation and anti-VEGF Injection Treatment in Radiation Retinopathy

Abstract

Background Radiation retinopathy can lead to a considerable reduction in visual acuity. We report 2 cases of radiation retinopathy in which a therapy with combined intravitreal anti-VEGF injection and laser photocoagulation (LPC) was used.

Patient History Two 55-year-old women were referred to our clinic with radiation retinopathy, in the first case unilaterally after radiation due to endocrine orbitopathy (P1), in the second case in both eyes after palliative cerebral radiation for metastatic breast cancer (P2). Both cases were treated with combined intravitreal anti-VEGF injection and focal LPC.

Therapy After the initiation therapy macular edema decreased considerably. One year after the beginning of therapy visual acuity increased in the first case from 0,05 to 0,16 p, in the second case from 0,5/0,4 to 0,6/0,5. Despite the positive response there is still continuing need for therapy in all three eyes.

Conclusions Combined anti-VEGF injection and LT can reduce macular edema due to radiation retinopathy. The follow-up observation shows the necessity of long-term care.

Zusammenfassung

Strahlenretinopatie ist eine Spätkomplikation bei Strahlentherapie und kann zu einem erheblichen Visusverlust führen. Anti-VEGF-Therapie führt zum deutlichen Rückgang des Makulaödems und kann mit fokaler Laserkoagulation kombiniert werden, vor allem wenn eine signifikante Störung der Blut-Retina-Schranke und gleichzeitig ziemlich große avaskuläre Areale im Makulabereich vorliegen. Strukturelle Verbesserungen der Netzhaut nach der Therapie können beobachtet werden (reduzierte Anzahl von Mikroaneurysmen und Resorption von harten Exsudaten). Trotz gutem Ansprechen auf die Therapie scheinen regelmäßige Kontrollen und Fortsetzung der Therapie notwendig zu sein.

Key words

radiation retinopathy - anti-VEGF - laser photocoagulation

Schlüsselwörter

Strahlenretinopathie - anti-VEGF - Laserkoagulation

^* Both authors equally contributed to this publication

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