Prospective controlled evaluation on radiotherapy of subfoveolar neovascularization |
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Authors: | Norbert Anders Holger Stahl Tony Walkow Norbert Hosten Peter Wust Christian Hartmann Josef Wollensak Alexander Dorn |
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Institution: | Klinik und Poliklinik für Augenheilkunde, Charité und Virchow-Klinikum, Medizinische Fakult?t der Humboldt-Universit?t zu Berlin, XX Klinik und Poliklinik für Strahlentherapie, Virchow-Klinikum, Medizinische Fakult?t der Humboldt-Universit?t zu Berlin, XX Berlin, XX
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Abstract: | Summary
Despite the successful therapy of subretinal neovascular membranes by laserphotocoagulation there are many problems to be
overcome. In the case of subfoveolar neovascularization, photocoagulation leads to a sudden decrease in visual acuity.Recently
radiotherapy is considered as an alternative. Complications and effectivity were evaluated in this prospective and randomized
trial. The initial results are presented.
Patients and methods: There are 76 patients (51 women, 25 men, average age 77.7 ± 8.6 years) included in the prospective randomized study. All
of them show subfoveolar neovascular membranes in FLA and a decrease in visual acuity between 0.05 and 0.5. They were randomly
assigned to either the radiotherapy or the control group. Radiotherapy was done within 6 days by 6 × 2 Gy (6 MV photons).
The follow-up was at 4 weeks, after 3 months, after 6 months and then every 6 months after the end of radiotherapy. On average
the follow-up is at 15.1 months.
Results: Concerning age and visual acuity before therapy, the control group and the radiotherapy group were not significantly different.
At 4 weeks after radiotherapy, visual acuity was 0.13 ± 0.46 (LogMAR). After 12 months, visual acuity at a distance was 0.11
± 0.30 in the therapy group and 0.09 ± 0.13 (P = 0.838) in the control group. Patients with a preoperative visual acuity better than 0.2 improved more after radiotherapy.
Metamorphopsy improved in 75 % of the therapy group. The following complications could be observed: In the control group 3
patients suffered subretinal bleeding, in the radiotherapy group 3 patients, respectively.
Conclusions: At present, the follow-up is too short to recommend radiotherapy as a standard procedure in the case of subfoveolar neovascularization.
The results in patients with a better preoperative visual acuity encourage us to continue this study.
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Keywords: | Age dependent macular degeneration • Laser therapy • Radiotherapy • Subfoveolar neovascularization |
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