{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T02:40:46Z","timestamp":1777603246615,"version":"3.51.4"},"reference-count":74,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Radiation optic neuropathy (RON) generally follows radiation therapy that exceed 50 Gy to the visual axis and occurs within three years of therapy. Currently, there are no universally accepted treatments or prophylaxis for RON. The review aimed to examine the efficacy of all treatments and prophylaxis for RON.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, Embase, the Cochrane Library, and gray literature were searched to December 2020. Studies on treatment(s) and\/or prophylaxis of RON were included. Results were meta-analyzed using a random-effects model. Primary outcomes included the proportions of patients who experienced improvement, no change, or worsening of visual acuity (VA) for each treatment. Secondary outcome was the incidence of RON for studies on prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 50 studies (n\u2009=\u20095397) were included. Meta-analysis (n\u2009=\u20091752) showed significantly lower incidence of RON in patients who underwent intravitreal anti-VEGF prophylaxis compared to control (RR 0.64, 95%CI [0.48, 0.86]) for uveal melanoma. Intravitreal anti-VEGF injections (n\u2009=\u200968), hyperbaric oxygen therapy alone (n\u2009=\u200914), and pentoxifylline (n\u2009=\u20095) resulted in improved or stable vision \u22641 logMAR in 54.5%, 42.9%, and 40.0% of patients, respectively. Systemic corticosteroids (n\u2009=\u200982), anticoagulants (n\u2009=\u200912), and systemic bevacizumab (n\u2009=\u20097) showed improved or stable vision \u22641 logMAR in 17.1%, 33.3%, and 14.3% of patients, respectively. Overall risk of bias was low, but evidence was limited to retrospective studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intravitreal anti-VEGF injections reduced incidence of RON in irradiated uveal melanoma patients. Systemic corticosteroids, systemic bevacizumab, and warfarin alone are likely ineffective treatments. Early hyperbaric oxygen therapy and intravitreal anti-VEGF injections were most effective among those investigated and require further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721221085409","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T11:08:14Z","timestamp":1646824094000},"page":"3129-3141","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Treatment and prophylaxis of radiation optic neuropathy: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"32","author":[{"given":"Caberry W.","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Surgery, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6611-6490","authenticated-orcid":false,"given":"Ishraq","family":"Joarder","sequence":"additional","affiliation":[{"name":"Faculty of Science, University of Toronto, Scarborough, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4911-9152","authenticated-orcid":false,"given":"Jonathan A.","family":"Micieli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Kensington Vision and Research Centre, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"bibr1-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0000000000000670"},{"key":"bibr2-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/00041327-200409000-00014"},{"key":"bibr3-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(90)32582-4"},{"key":"bibr4-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/00041327-200409000-00003"},{"key":"bibr5-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.12.009"},{"key":"bibr6-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(94)90346-8"},{"key":"bibr7-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02161"},{"key":"bibr8-11206721221085409","doi-asserted-by":"publisher","DOI":"10.3171\/sup.2004.101.supplement3.0390"},{"key":"bibr9-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(85)33898-8"},{"key":"bibr10-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e31820d5361"},{"key":"bibr11-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2009.09.029"},{"key":"bibr12-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(86)33617-0"},{"key":"bibr13-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005005.pub4"},{"key":"bibr14-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2019.5132"},{"key":"bibr15-11206721221085409","first-page":"59","volume":"41","author":"Li CQ","year":"2014","journal-title":"Undersea Hyperb Med"},{"key":"bibr16-11206721221085409","doi-asserted-by":"crossref","first-page":"151","DOI":"10.47102\/annals-acadmedsg.V35N3p151","volume":"35","author":"Levy RL","year":"2006","journal-title":"Ann Acad Med Singap"},{"key":"bibr17-11206721221085409","doi-asserted-by":"publisher","DOI":"10.3109\/01658109609044633"},{"key":"bibr18-11206721221085409","volume-title":"Cochrane handbook for systematic reviews of interventions version 5.1.0","author":"Higgins JPT","year":"2011"},{"issue":"10","key":"bibr19-11206721221085409","first-page":"e1","volume":"62","author":"Liberati A","year":"2009","journal-title":"BMJ (Clinical research ed)"},{"key":"bibr20-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"bibr21-11206721221085409","volume-title":"GRADEpro GDT","author":"The Cochrane Collaboration","year":"2017"},{"key":"bibr22-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"bibr23-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-0981"},{"key":"bibr24-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-0981"},{"key":"bibr25-11206721221085409","first-page":"332","volume":"80","author":"Patel H","year":"2017","journal-title":"Conselho Brasileiro De Oftalmologia"},{"key":"bibr26-11206721221085409","volume-title":"Review manager (RevMan) [computer program]. version 5.3","author":"The Cochrane Collaboration","year":"2014"},{"key":"bibr27-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.333.7568.597"},{"key":"bibr28-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1080\/08820538.2017.1346133"},{"key":"bibr29-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)77019-9"},{"key":"bibr30-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e3182464c88"},{"key":"bibr31-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-233706"},{"key":"bibr32-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2012.01.013"},{"key":"bibr33-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(19)30420-1"},{"key":"bibr34-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(97)30084-0"},{"key":"bibr35-11206721221085409","doi-asserted-by":"publisher","DOI":"10.3109\/01676830.2011.603458"},{"key":"bibr36-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e31828292b8"},{"key":"bibr37-11206721221085409","first-page":"T2","volume":"114","author":"Kim IK","year":"2016","journal-title":"Trans Am Ophthalmol Soc"},{"key":"bibr38-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.08.039"},{"key":"bibr39-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/APO.0000000000000271"},{"key":"bibr40-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-016-3429-4"},{"key":"bibr41-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1159\/000487543"},{"key":"bibr42-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.11.075"},{"key":"bibr43-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2019.07.004"},{"key":"bibr44-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181c3fd00"},{"key":"bibr45-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-010-0336-0"},{"key":"bibr46-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.11.068"},{"key":"bibr47-11206721221085409","first-page":"50","volume":"13","author":"Fu BD","year":"2011","journal-title":"Neuro Oncol"},{"key":"bibr48-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e3182607381"},{"key":"bibr49-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0000000000000765"},{"key":"bibr50-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noz126.361"},{"key":"bibr51-11206721221085409","first-page":"S56","volume":"41","author":"Mechtler L","year":"2017","journal-title":"Neuro-Ophthalmology"},{"key":"bibr52-11206721221085409","doi-asserted-by":"crossref","unstructured":"Ayoub E, Guy JB, Moulin N, et al. Radiation optic neuropathy and stroke suspicion. JMV-Journal de Medecine Vasculaire. France: Elsevier Masson SAS; 2020. p. 232\u2013233. Vol. 45.","DOI":"10.1016\/j.jdmv.2020.04.005"},{"key":"bibr53-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1007\/BF03343560"},{"key":"bibr54-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.2004.00825.x"},{"key":"bibr55-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.2004.00824.x"},{"key":"bibr56-11206721221085409","doi-asserted-by":"crossref","first-page":"A37","DOI":"10.1212\/WNL.56.1.37","volume":"56","author":"Venketasubramanian N","year":"2001","journal-title":"NEUROLOGY"},{"key":"bibr57-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e318276d4b8"},{"key":"bibr58-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.124.10.1428"},{"key":"bibr59-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.07.038"},{"key":"bibr60-11206721221085409","doi-asserted-by":"crossref","unstructured":"Falavarjani KG, Nguyen QD. Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature. Eye (Basingstoke). UK: Nature Publishing Group; 2013. p. 787\u2013794. Vol. 27.","DOI":"10.1038\/eye.2013.107"},{"key":"bibr61-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1038\/362841a0"},{"key":"bibr62-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-014-1391-8"},{"key":"bibr63-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.10.010"},{"key":"bibr64-11206721221085409","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-198734010-00003"},{"key":"bibr65-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1E186"},{"key":"bibr66-11206721221085409","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.60.3.0589"},{"key":"bibr67-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.2004.00809.x"},{"key":"bibr68-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-04699-z"},{"key":"bibr69-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-006-9256-4"},{"key":"bibr70-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1667\/RR3124"},{"key":"bibr71-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181fbe2bf"},{"key":"bibr72-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)81019-0"},{"key":"bibr73-11206721221085409","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2016.0718"},{"key":"bibr74-11206721221085409","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.04.1518"}],"container-title":["European Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11206721221085409","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11206721221085409","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11206721221085409","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T19:46:15Z","timestamp":1777405575000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/11206721221085409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,9]]},"references-count":74,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1177\/11206721221085409"],"URL":"https:\/\/doi.org\/10.1177\/11206721221085409","relation":{},"ISSN":["1120-6721","1724-6016"],"issn-type":[{"value":"1120-6721","type":"print"},{"value":"1724-6016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,9]]}}}