Radiotherapie von choroidalen Neovaskularisationen (CNV) bei altersabhängiger Makuladegeneration (AMD)1

Abstract

The natural course of occult CNV could not be improved by irradiation with 10 or 36 Gy. In eyes with classic CNV a VA of > or = 0.1 was maintained significantly more often in irradiated eyes than in those of the control group. Treatment with 36 Gy however was associated with an unacceptable incidence of radiation retinopathy.

External beam radiotherapy for age-related macular degeneration causes transient objective changes in tear-film function

“…Because of the moderate radiation dosage used in AMD, radiation retinopathy and optic neuropathy are rare [14,17,18]. Cataract formation has been observed, and transient subclinical lens transparency changes have been described [1,3].…”

“…Thölen et al [17] described 2 out of 16 patients with persistent sicca problems after 36 Gy radiation and 5 out of 16 patients with subjective transient local irritation after 10 Gy radiation. Hart et al [8] found that 1 of 53 patients complained of transient conjunctival irritation with a 10-15 Gy treatment regimen.…”

“…Whereas radiation retinopathy, optic neuropathy, and cataract formation appeared seldom [7,8,11,13,17], epiphora or transient conjunctival irritation was described quite frequently [5,7,8,9,11,13,16,17,18]. The appearance of conjunctival side effects has only been documented according to the patients' subjective symptoms.…”

Long-Term Results after External Radiotherapy in Age-Related Macular Degeneration

“…After irradiation of 118 patients with 20 Gy, Schittkowski et al did not find a persistent effect on vision [21]. Thölen et al treated 53 patients with 10 and 36 Gy in five and 18 fractions, respectively [26]. The natural course of occult CNV could not be influenced; a 25% incidence of radiation retinopathy in the group with 36 Gy was observed.…”

Results of radiotherapy of subfoveal neovascularization with 16 and 20 Gy

“…5 The radiation tolerance of eyes with ARMD may be reduced due to the underlying retinal changes so that the therapeutic window is probably small. 5,36,40 So far, only one of the above studies using high dose per fraction has demonstrated an increased rate of radiation late effects: 15 of 212 patients developed retinopathy, choroidal teleangiectasia, optic neuropathy, or branch vein occlusion of varying severity within 2 years of treatment. 5 This study reported the longest follow-up and had therefore a higher probability of recording late effects.…”