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Clinical Trial
. 2004 Jan;88(1):114-9.
doi: 10.1136/bjo.88.1.114.

Radiotherapy for recurrent choroidal neovascularisation complicating age related macular degeneration

D M Marcus  1 , W C Sheils, J O Young, S B McIntosh, M H Johnson, J Alexander, C N Samy
Affiliations
Clinical Trial

Radiotherapy for recurrent choroidal neovascularisation complicating age related macular degeneration

D M Marcus et al. Br J Ophthalmol. 2004 Jan.

Abstract

Aims: To report the safety and visual outcome data of external beam irradiation for recurrent choroidal neovascularisation complicating age related macular degeneration.

Methods: Eighteen consecutive eyes received external beam irradiation with seven fractions of 2 Gy (total dose 14 Gy). The next 16 consecutive eyes received external beam irradiation with five fractions of 3 Gy (total dose 15 Gy). Main outcome measure was change in visual acuity. Secondary outcome variables were contrast sensitivity and fundus photographic/fluorescein angiographic progression.

Results: The 3 Gy fraction group lost fewer lines of distance visual acuity at the three and six month follow up. At one year follow up, this difference was not maintained with 2 Gy fraction and 3 Gy fraction eyes. At one year follow up a decrease in visual acuity of three or more lines (moderate visual loss) occurred in 58% of 2 Gy and 42% of 3 Gy fraction eyes (p<0.36). At one year follow up a decrease in visual acuity of six or more lines (severe visual loss) occurred in 41% of 2 Gy eyes and 17% of 3 Gy eyes (p<0.23). At three months follow up, 3 Gy eyes were less likely (0%) than 2 Gy eyes (47%) to show moderate visual loss (p<0.003). However, Kaplan Meier curves estimate a significantly lower rate of severe visual loss in the 3 Gy group (p = 0.02). There were no significant differences in contrast sensitivity loss or fluorescein angiographic stabilisation rates. No evidence of radiation toxicity was observed.

Conclusion: Our results are consistent with trends for a palliative benefit with higher fraction sizes and doses. The radiobiologic differences between low and high fraction size groups in this study are modest and correlate with the modest and short term difference in visual outcomes. These trends support further investigation of radiotherapy using fraction sizes of 4 Gy or higher.

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Figures

Figure 1
Figure 1
Line graph showing the number of lines of distance visual acuity loss over time for the low and high dose groups.
Figure 2
Figure 2
Kaplan-Meier curves showing proportion of eyes with (A) three or more and (B) six or more lines of visual acuity loss over time for the low and high dose groups.
Figure 3
Figure 3
Line graph showing the change in contrast sensitivity over time for the low and high dose groups.
Figure 4
Figure 4
Bar graph showing percentage of eyes with angiographic and/or photographic worsening at different time points for each group.
See this image and copyright information in PMC

References

    1. Macular Photocoagulation Study Group. Laser photocoagulation for juxtafoveal choroidal neovascularization: five-year results from randomized clinical trials. Arch Ophthalmol 1994;112:500–9. - PubMed
    1. Macular Photocoagulation Study Group. Argon laser photocoagulation for neovascular maculopathy after five years: results from randomized clinical trials. Arch Ophthalmol 1991;109:1109–14. - PubMed
    1. Macular Photocoagulation Study Group. The influence of treatment extent on the visual acuity of eyes treated with krypton laser for juxtafoveal choroidal neovascularization. Arch Ophthalmol 1995;113:190–4. - PubMed
    1. Sorenson JA, Yannuzzi LA, Shakin JL. Recurrent subretinal neovascularization. Ophthalmology 1985;92:1059–73. - PubMed
    1. Macular Photocoagulation Study Group. Recurrent choroidal neovascularization after argon laser photocoagulation for neovascular maculopathy. Arch Ophthalmol 1986;104:503–12. - PubMed

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