[Radiotherapy of occult neovascularization in senile macular degeneration: initial results of a pilot study].
BACKGROUND
AMD is the leading cause of legal blindness in people aged of more than 50 in industrialized countries. Occult neovascularization accounts for more than 70% of all exsudatives forms of AMD. Radiotherapy has been proposed as a possible treatment for retrofoveal neovascularization. We present the first results of a pilot study actually ongoing at the AMD Center in Creteil.


METHODS
44 patients (46 eyes) presenting occult choroidal neovascularization involving the fovea, aged of > 50 years and with a minimal visual acuity of at least 0.1 were included. They received a total dose of 16 Gy in 4 sessions of 4 Gy. All the patients were checked after 3 months.


RESULTS
Visual acuity was globally maintained (> 0.1 in 93% of the eyes). Only one eye suffered a significant loss of vision (> 6 lines) and 11% suffered a moderate loss of vision (> 3 lines). Moreover 67% of eyes still had a near vision of 0.5 or more with reading glasses. On fluorescein angiography 17.5% of the eyes experienced an increase of the size of the occult neovascularization of > 0.5 Disk Area (DA), 76% showed no modification and 6.5% demonstrated a decrease in size of > 0.5 DA.


CONCLUSIONS
As it has been shown that the antimitotic action of radiotherapy is most effective after 3 months, the present results suggest better evolution than natural history. However, as occult choroidal neovascularization is a slow-evolving disease further follow-up is needed to confirm it.
Clinique d'Ophtalmologie, HCUG, CH-1211 Genève.
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Donati
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Pournaras
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Soubrane
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Quaranta
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Coscas
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D000368:Aged; D002829:Choroid / Q000098:blood supply*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000532:radiotherapy*; D010865:Pilot Projects; D015861:Retinal Neovascularization / Q000532:radiotherapy*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000528:radiation effects