External beam radiation therapy for choroidal neovascularization

Visual function after strontium‐90 plaque irradiation in patients with age‐related subfoveal choroidal neovascularization

“…These results are encouraging and better than our results, in which 28% of the treated eyes lost 6 or more lines at 24 months. Also some unfavourable results of external beam radiotherapy have been reported (Spaide et al 1998;Stalmans et al 1997). In the study by Spaide et al (1998), 49.4% of irradiated eyes vs 38.1% of the control eyes had lost 3 or more lines of VA after 1 year.…”

“…In some studies, however, the results have not been so favourable (Spaide et al 1998;Stalmans et al 1997). To avoid the problems of external beam irradiation, such as the need for multiple procedures, difficulties in focusing the beam onto the small foveal area and irradiation to other parts of the eye and periocular structures, we treated eyes with subfoveal CNVMs using a local strontium-90 ( 90 Sr) plaque applicator.…”

Radiotherapy for age-related macular degeneration: no more pilot studies please

“…18 Since then a multitude of small pilot studies using standard fractions of 2-3 Gy with a total dose of 10-20 Gy have been published, some showing better maintenance of visual acuity in treated eyes, [11][12][13][14]19 while others failed to show any benefit. 15,[20][21][22] Overall, prior to the study by Hoeller et al there have been 10 randomised control trials (RCT), 15,[23][24][25][26][27][28][29][30]30,31 three nonrandomised trials 15,21,32 and eight case series each with over 100 people in the study 22,[33][34][35][36][37][38][39] (see Table 1). Among the above RCTs, three studies demonstrated a significant reduction in visual loss when comparing radiotherapy to very lowdose (effectively sham) radiotherapy 25 or observation.…”

Results of radiotherapy of subfoveal neovascularization with 16 and 20 Gy

“…27 The degenerative process itself and the persistence of the stimuli that upregulate the growth factors are probably not altered by radiotherapy. 28 A variety of dose schedules has been employed in the recent decade. Low-dose radiotherapy with 4 Â 0.2-0.5 Gy was ineffective.…”

“…6,28,[30][31][32] In a group of 91 patients, radiotherapy with 10 Gy in five fractions was not effective in comparison to a historical, well-defined, control group of untreated patients. 28 In an Austrian study with 14.4 Gy in eight fractions, 30 a German study of 73 patients with classic ARMD with 16 Gy in eight fractions, 31 and a similar study of 69 patients with classic or occult CNV, the VA at 1 year was similar to the expected natural course of disease (25,37, and 38%, respectively). 6 Finally, a German multicentre study, testing 16 Gy in eight fractions vs sham irradiation in 205 patients, has proven radiotherapy with this dose to be ineffective.…”