Ten-year follow-up of eyes treated with stereotactic fractionated external beam radiation for neovascular age-related macular degeneration
Open accessAbstract
PURPOSE: To determine the long-term effects of stereotactic fractionated external beam radiation on eyes treated for neovascular age-related macular degeneration. METHODS: A retrospective review of all eyes treated with stereotactic fractionated external beam radiation (20-40 Gy, 2-Gy fractions) between 1997 and 2000 was performed to identify eyes with ≥ 2-year follow-up for analysis. A subset was imaged prospectively using a high-resolution Fourier-domain optical coherence tomography. RESULTS: Among 94 eyes treated, 33 eyes (32 subjects) had ≥ 2-year follow-up information (mean follow-up, 6.2 years; range, 2-10 years). Final visual acuity ranged from 20/50 to no light perception. Final macular findings included central geographic atrophy (49%), disciform scar (30%), and active choroidal neovascular membrane (9%). Fourier-domain optical coherence tomography images of three eyes with geographic atrophy revealed photoreceptor layer loss within areas of geographic atrophy with intact retinal morphology in areas of radiation exposure outside geographic atrophy. Radiation retinopathy was suspected in 18% and confirmed by fluorescein angiography in 15%, ranging from mild to neovascular glaucoma/phthisis bulbi (2 eyes). Mean time from stereotactic fractionated external beam radiation to development of radiation retinopathy was 5.4 years (range, 1-10 years). CONCLUSION: A moderate rate of delayed radiation retinopathy was noted in eyes with neovascular age-related macular degeneration treated with stereotactic fractionated external beam radiation. Geographic atrophy was a common finding.
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Scar formation after radiotherapy for neovascular age-related macular degeneration has been reported.
“Scar that develops after radiotherapy for nvAMD has been described.6,7”
From Risk of Scar in the Comparison of Age-related Macular Degeneration Treatments Trials (2014) · cites this paper as [7]
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Risk of Scar in the Comparison of Age-related Macular Degeneration Treatments Trials
Daniel, E., Toth, C. A., Grunwald, J. E., Jaffe, G. J., Martin, D. F., Fine, S. L., Huang, J., Ying, G.-S., Hagstrom, S. A., Winter, K., et al. (2014) · Ophthalmology · doi:10.1016/j.ophtha.2013.10.019 · Cited by 335 · see citing works
“Scar that develops after radiotherapy for nvAMD has been described.(6,7) However, treatment patterns for nvAMD have changed in the past decade, and nearly all patients now receive treatment with intravitreal injections of drugs that target vascular endothelial growth factor (VEGF).”
- Authors
- Trikha, R., Morse, L. S., Zawadzki, R. J., Werner, J. S., & Park, S. S.
- Affiliations
- University of California Davis Medical Center (US)
- Venue
- Retina
- Published
- 2011-07
- Volume
- 31
- Issue
- 7
- Pages
- 1303-1315
- ISSN
- 0275-004X (ISSN-L)
- PMC
- PMC3379006
- OpenAlex
- W2330219133
- Cited by
- 19
- References
- 44
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 1 · 2020: 2 · 2018: 1 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 4 · 2012: 1
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Retina (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- U.S. Public Health Service (014743)
- National Eye Institute (R01EY014743)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Ophthalmology › Ocular Oncology and Treatments
- Health Sciences › Medicine › Ophthalmology › Ocular and Laser Science Research
- Keywords
- neovascular age-related macular degeneration, radiation retinopathy, geographic atrophy, choroidal neovascularization, disciform scar, long-term visual outcomes, neovascular glaucoma, phthisis bulbi
- MeSH terms
- Aged, Aged, 80 and over, Female, Fluorescein Angiography, Follow-Up Studies, Fourier Analysis, Humans, Macular Degeneration, Male, Middle Aged, Radiation Dosage, Radiation Injuries, Radiotherapy, Retrospective Studies, Stereotaxic Techniques, Time Factors, Visual Acuity, Dose Fractionation, Radiation, Choroidal Neovascularization, Photoreceptor Cells, Vertebrate, Tomography, Optical Coherence, Geographic Atrophy
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