Q&A: Kapil Mishra on radiation retinopathy in uveal melanoma

(Photo of Kapil Mishra, MD, at Retina World Congress 2025)

Kapil Mishra, MD, assistant professor of ophthalmology at the Gavin Herbert Eye Institute, University of California Irvine, who specializes in vitreoretinal surgery and medical diseases as well as ocular oncology. He discussed an overview of radiation retinopathy and its challenges in treating uveal melanoma with the Ophthalmology Times team. He presented "Radiation Retinopathy: Future Strategies" during the 2025 Retina World Congress annual meeting.

Note: This conversation has been lightly edited for clarity.

Ophthalmology Times: You are presenting at Retina World Congress 2025. What would you say are the key highlights from your presentation on radiation retinopathy?

Kapil Mishra, MD: I'm really excited to present about radiation retinopathy and current and future strategies. Radiation retinopathy is a very challenging disease. It's very resistant to treatment, and it's pretty prevalent for patients who are undergoing treatment for uveal melanoma. There are a lot of exciting things in ocular oncology that either directly address radiation retinopathy or indirectly address i, and so my talk will be highlighting a couple of those ideas.

OT: Related to oncology, where are we at with current treatments and how patients reach the point of radiation retinopathy?

Mishra: When we think about treatment for ocular oncology, and specifically uveal melanoma, there's this paradigm that we follow that we don't typically consider in the world of ophthalmology, because we're so isolated in many ways. With ocular oncology, it's very similar to the rest of the body in the sense that life trumps all, and then followed by that, there's globe preservation, and then after that, there is vision. So as long as we're able to salvage life and salvage globe, then we can focus on vision. When it comes to treatment for uveal melanoma, we've done a great job in terms of globe salvation, which hopefully leads to life salvation, just in the sense that our treatments have been very effective in local tumor control. The third portion is really in terms of vision, which unfortunately has taken a back seat to these others, understandably so. So when patients undergo radiation treatment for uveal melanoma, about half of them have vision loss of 2200 or worse, according to the collaborative ocular melanoma study. So there's a lot of space to be able to improve those odds with current treatments and future strategies.