to report the effective treatment of radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma with a dexamethasone 0.7-mg ( ozurdex ) intravitreal implant . a 65-year - old caucasian woman was suffering from radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma on her left eye . she had undergone one intravitreal injection of 0.5 mg bevacizumab ( avastin , genentech / roche ) in the following months without functional or anatomical improvement . seven months after the development of radiation macular edema , she received a single intravitreal injection of dexamethasone 0.7 mg ( ozurdex ) . four weeks following the injection , her best - corrected visual acuity improved from 0.3 to 0.5 . radiation macular edema resolved with a reduction of central retinal thickness from 498 m before ozurdex injection to 224 m after ozurdex injection , as measured by oct scan . dexamethasone 0.7 mg ( ozurdex ) has proven to be an effective treatment option in retinal vein occlusion and noninfectious uveitis . it can also be considered as off - label treatment in radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma . radiation retinopathy is a predictable complication after radioactive scleral plaque application for treatment of intraocular tumors , most commonly choroidal melanoma . macular edema is a common manifestation of radiation retinopathy that may lead to severe visual loss . according to guyer et al . , it was the most frequent and early finding after proton beam therapy for paramacular choroidal tumors , with 87% of 218 patients who developed macular edema . other studies suggest rates of radiation maculopathy from plaque radiotherapy of 18% , 23% , and 42.8% . these include laser photocoagulation , photodynamic therapy , pentoxifylline   and intravitreal bevacizumab [ 9 , 10 ] . corticosteroids are potent anti - inflammatory agents that can counteract many of the pathological processes thought to play a role in the development of macular edema . recently , a sustained - release dexamethasone implant ( ozurdex ) proved to be effective for the treatment of macular edema secondary to a variety of underlying diseases with a potentially lower rate of adverse events . there are no cases of radiation macular edema after ruthenium ( ru)-106 plaque brachytherapy for choroidal melanoma resolved by an intravitreal dexamethasone 0.7-mg implant described so far in the literature . we report a case of radiation macular edema after ru-106 brachytherapy for a choroidal melanoma , refractory to a previous treatment with intravitreal bevacizumab , and resolved with significant improvement of visual function following an intravitreal injection of dexamethasone 0.7 mg . a 65-year - old caucasian woman developed radiation macular edema 24 months following ru-106 plaque brachytherapy for a choroidal melanoma on her left eye ( fig . she underwent one intravitreal injection of 0.5 mg bevacizumab ( avastin , genentech / roche ) in the following months without functional or anatomical improvement . seven months after the development of radiation macular edema , she received a single intravitreal injection of dexamethasone 0.7 mg ( ozurdex ) as off - label treatment . four weeks following the injection , her best - corrected visual acuity ( bcva ) improved from 0.3 to 0.5 . 1b ) with a reduction of central retinal thickness from 498 m before ozurdex injection ( fig . her condition has been stable for at least 5 months now , as seen on the last examination , with bcva 0.6 and resolved macular edema in the treated eye . shields et al .   reported the use of intravitreal triamcinolone ( 4 mg / ml ) in a prospective , nonrandomized , single - center case series of 31 patients with visually symptomatic radiation - induced macular edema after plaque radiotherapy . they reported that visual acuity was stable or improved in 91% of patients by one month and 45% by six months ; they also found a decrease in the mean central subfield foveal thickness measured by oct . despite the potential benefits , intravitreal injection of triamcinolone acetate is associated with side effects , including glaucoma , cataracts , retinal detachment , and endophthalmitis [ 13 , 14 ] . also intravitreal bevacizumab has been evaluated as a treatment option for radiation maculopathy secondary to plaque radiotherapy [ 9 , 10 ] . our patient was initially treated with an intravitreal injection of bevacizumab which has not proved effective . gupta et al .   stated that intravitreal injection of bevacizumab for treatment of radiation maculopathy caused by plaque radiotherapy was not useful for long - standing macular edema or when direct irradiation was received by the fovea . one of the main mechanisms of the chronic macular edema is the alteration of muller cells functionality ; it has been experimentally shown that steroids , by reducing the osmotic swelling of the muller 's cells , improve their functionality and reduce the macular edema . this could indicate that dexamethasone implant ( ozurdex ) might be an effective treatment option not only in retinal vein occlusion and noninfectious uveitis , but can also be considered as off - label treatment in radiation macular edema after ru-106 plaque brachytherapy for choroidal melanoma .
purposeto report the effective treatment of radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma with a dexamethasone 0.7-mg ( ozurdex ) intravitreal implant.methodsan interventional case report with optical coherence tomography ( oct ) scans.resultsa 65-year - old caucasian woman was suffering from radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma on her left eye . 
 she had undergone one intravitreal injection of 0.5 mg bevacizumab ( avastin , genentech / roche ) in the following months without functional or anatomical improvement . 
 seven months after the development of radiation macular edema , she received a single intravitreal injection of dexamethasone 0.7 mg ( ozurdex ) . 
 four weeks following the injection , her best - corrected visual acuity improved from 0.3 to 0.5 . 
 radiation macular edema resolved with a reduction of central retinal thickness from 498 m before ozurdex injection to 224 m after ozurdex injection , as measured by oct scan.conclusiondexamethasone 0.7 mg ( ozurdex ) has proven to be an effective treatment option in retinal vein occlusion and noninfectious uveitis . 
 it can also be considered as off - label treatment in radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma .