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INTRAVITREAL ANTI-VEGF THERAPY FOR OCULAR METASTASIS IN BREAST CANCER

DRAGOS SERBAN ^1,2#, ANA MARIA DASCALU ^1,3*, LAURA CARINA TRIBUS ^4,5#, DANIEL OVIDIU COSTEA ^6,7#, CORNELIU TUDOR ², TOKTAM SAHRANAVARD ⁸, RAMIN REZAEE ^8,9, DANIELA STANA ³, BOGDAN MIHAI CRISTEA ¹, MIHAIL SILVIU TUDOSIE ¹, FLORIN BOBIRCA ¹, BOGDAN SERBAN ¹, ION MOTOFEI ^1,10, TIBERIU TROTEA ^1,2, ANDREEA CRISTINA COSTEA ¹¹, DANIEL ALIN CRISTIAN ¹,12

1University of Medicine and Pharmacy “Carol Davila” Bucharest, Faculty of Medicine, Bucharest, Romania
² IVth Department of General Surgery, Emergency University Hospital Bucharest, Bucharest, Romania
³ Department of Ophthalmology, Emergency University Hospital Bucharest, Bucharest, Romania
⁴ University of Medicine and Pharmacy “Carol Davila” Bucharest, Faculty of Dental Medicine, Bucharest, Romania 5Departemnt of Gastroenterology, Ilfov Clinic Hospital, Bucharest, Romania
⁶ Faculty of Medicine, Ovidius University, Constanta, Romania
⁷ First Surgery Department, Emergency County Hospital, Constanta, Romania
⁸ International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
⁹ Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
¹⁰ Department of Surgery, “Sf. Pantelimon” Emergency Hospital, Bucharest, Romania
¹¹ Diaverum Nephrology and Dialysis Clinic, Constanta, Romania
¹² General Surgery Department, Colțea Clinic Hospital Bucharest, Romania

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Ocular metastases are the most common form of malignancy encountered in ophthalmology, in most cases associated with breast cancer as the primary tumour. Standard local therapy in case of ocular metastases that do not respond to systemic chemotherapy consists of external irradiation or brachytherapy, with multiple disadvantages related to the required logistics and multiple sessions as well as serious post-radiotherapy complications. The present systematic review discusses the efficiency and safety of intravitreal therapy with anti-vascular endothelial growth factor (anti-VEGF) agents used against choroidal metastases secondary to breast cancer. After an extensive search on PubMed, Google scholar and Web of science databases, 15 articles presenting data on 18 patients were included. The injected doses varied between 1.25 and 4 mg/session, with a monthly repetition of 3.9 ± 1.9 sessions. After treatment, it was reported that tumour size decreased in size in 94.5% of cases, the subretinal fluid decreased or resolved in 73.3% of cases, and vision improved in 61.1% of cases. The intravitreal injection of anti-VEGF agents as a simple and easy therapeutic approach that is free from the local ocular post-radiotherapy complications, can be considered a local adjuvant therapy to systemic chemotherapy.