Clinicopathological correlation of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration

Aisenbrey, S.; Lafaut, B. A.; Reynders, S.; Szurman, Peter; Grisanti, Swaantje; Broecke, C. Vanden; Walter, Peter; Bartz‐Schmidt, Karl Ulrich

doi:10.1007/s00417-003-0634-8

Cited by 4 publications

(1 citation statement)

References 42 publications

(45 reference statements)

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“…Scarring is a key contributor to vision loss in nAMD. Third, radiation leads to the death of rapidly dividing endothelial cells — the main pathological component of CNV complexes [8]. …”

Section: Introductionmentioning

confidence: 99%

StereoTactic radiotherapy for wet Age-Related macular degeneration (STAR): study protocol for a randomised controlled clinical trial

Neffendorf

Desai

Wang

et al. 2016

Trials

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BackgroundThe standard of care for neovascular age-related macular degeneration (nAMD) involves ongoing intravitreal injections of anti-angiogenic drugs targeting vascular endothelial growth factor (VEGF). The most commonly used anti-VEGF drugs are ranibizumab, bevacizumab and aflibercept. The main objective of the STAR trial is to determine if stereotactic radiotherapy can reduce the number of anti-VEGF injections that patients with nAMD require.Methods/designSTAR is a multicentre, double-masked, randomised, sham-controlled clinical trial. It evaluates a new device (manufactured by Oraya, Newark, CA, USA) designed to deliver stereotactic radiotherapy (SRT) to nAMD lesions. The trial enrols participants with chronic, active nAMD. Participants receive a single SRT treatment (16 Gy or sham) with a concomitant baseline intravitreal injection of 0.5 mg ranibizumab. Thereafter, they attend every month for 24 months, and ranibizumab is administered at the visit if retreatment criteria are met. The primary outcome is the number of pro re nata ranibizumab injections during the first 24 months. Secondary outcomes include visual acuity, lesion morphology, quality of life and safety. Additional visits occur at 36 and 48 months to inspect for radiation retinopathy.The target sample size of 411 participants (randomised 2:1 in favour of radiation) is designed to detect a reduction of 2.5 injections against ranibizumab monotherapy, at 90% power, and a significance level (alpha) of 0.025 (one-sided two-sample t test). This gives 97% power to detect non-inferiority of visual acuity at a five-letter margin. The primary analyses will be by intention to treat.DiscussionThe safety and efficacy outcomes will help determine the role of SRT in the management of chronic, active nAMD.Trial registrationInternational Standard Randomised Controlled Trial Number: ISRCTN12884465. Registered on 28 November 2014. ClinicalTrials.gov: NCT02243878. Registered on 17 September 2014.

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“…Scarring is a key contributor to vision loss in nAMD. Third, radiation leads to the death of rapidly dividing endothelial cells — the main pathological component of CNV complexes [8]. …”

Section: Introductionmentioning

confidence: 99%

StereoTactic radiotherapy for wet Age-Related macular degeneration (STAR): study protocol for a randomised controlled clinical trial

Neffendorf

Desai

Wang

et al. 2016

Trials

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In vitro evaluation of simulated stereotactic radiotherapy for wet age-related macular degeneration on three different cell lines

Vounotrypidis

Hillenmayer

Wertheimer

et al. 2021

Sci Rep

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Low energy stereotactic radiotherapy has been proposed for the treatment of neovascular age related macular degeneration. We investigated the in vitro effect of the radiotherapy on pericytes, retinal pigment epithelium and endothelial cells. Primary human retinal pigment epithelium cells, human umbilical vein endothelial cells and human pericytes from Placenta were cultivated. In a pairwise protocol, one plate was irradiated at a dose of 16 Gy, while the second plate served as a non-irradiated control. Thereafter, cells were cultivated either in serum-free (non-permissive) or serum-stimulated (permissive) conditions. A life/dead assay, an XTT and a BrdU assay were performed up to 7 days after irradiation. No cell death occurred at any timepoint in any cell line after treatment nor in the control. Compared to the unirradiated controls, cell viability and metabolic activity were significantly reduced in irradiated cells in the XTT assay, except for non-permissive RPE cells. In the BrdU assay, proliferation was inhibited. While no cell death was detected in vitro, viability and proliferative capacity of all cell lines were significantly reduced. Therefore, it seems that low energy stereotactic radiotherapy inhibits angiogenesis without a direct induction of apoptosis but influencing microvascular function and stability.

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16 Gy low-voltage x-ray irradiation followed by as needed ranibizumab therapy for age-related macular degeneration: 12 month outcomes of a ‘radiation-first’ strategy

et al. 2012

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Clinicopathological correlation of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration

Cited by 4 publications

References 42 publications

StereoTactic radiotherapy for wet Age-Related macular degeneration (STAR): study protocol for a randomised controlled clinical trial

StereoTactic radiotherapy for wet Age-Related macular degeneration (STAR): study protocol for a randomised controlled clinical trial

In vitro evaluation of simulated stereotactic radiotherapy for wet age-related macular degeneration on three different cell lines

16 Gy low-voltage x-ray irradiation followed by as needed ranibizumab therapy for age-related macular degeneration: 12 month outcomes of a ‘radiation-first’ strategy

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