This 66YO male was examined following I-131 plaque radiotherapy and transpupillary thermotherapy for a type 1A, PRAME+ uveal malignant melanoma.
Vision was 20/80, and the tumor was regressing compared to its preoperative appearance (not shown). He was getting intravitreal injections every 4 months as prophylaxis against radiation retinopathy.
The patient returned 8 months later for an overdue examination with new peripapillary lipid from radiation papillopathy. The intravitreal Avastin injections were restarted, and the papillopathy gradually resolved.
Learning Points:
The incidence of radiation retinopathy is relatively high following plaque therapy for uveal malignant melanoma. Ongoing intravitreal injections greatly reduce this complication (see Fallico et al, Surv Ophthalmology 2021;66;441-460).
