Treatment of radiation maculopathy and radiation-induced macular edema: a systematic review.

Abstract Radiation maculopathy and radiation-induced macular edema are common sight-threatening complications following radiotherapy, especially that used for uveal melanoma. While many treatment and preventive strategies have been proposed, management of these conditions is still challenging. Initially, treatments were based on the use of retinal laser, but the outcomes were poor. Subsequently, management has shifted towards injection of intravitreal anti-vascular endothelial growth factor (anti-VEGF) or corticosteroids. We review current clinical evidence, which mostly relies on small sample-sized and retrospective studies, for the management of radiation maculopathy and, in particular, radiation-induced macular edema. At present, the first line approach is usually intravitreal anti-VEGF. Intravitreal dexamethasone implant may be an option for those with suboptimal response or contraindications to anti-VEGF agents. Possible preventive treatments that require future study are intravitreal bevacizumab and ranibizumab, peripheral laser photocoagulation, and subtenon triamcinolone acetonide.