Choroidal neovascular membranes: treatment with reirradiation.
OBJECTIVE
To evaluate re-treatment with an additional course of low-dose irradiation in patients with progressive or recurrent choroidal neovascular membranes (CNVMs).


METHODS
Ten patients who had received 14 Gy of external-beam radiation therapy in seven fractions for subfoveal CNVMs were found to have recurrent or persistent neovascularization at follow-up. They received an additional 15 Gy of radiation therapy administered in five daily fractions with a standard lens-sparing technique. Before reirradiation, visual acuity ranged from 20/80 to counting fingers. The median time between radiation courses was 6.5 months (range, 2-16 months). After re-treatment, the patients were followed up with angiography and visual field testing. The median follow-up was 18.5 months (range, 12-21 months).


RESULTS
Eight of 10 patients (80%) maintained their visual acuity at 1 year and three of seven (43%) at 18 months. Visual acuity was stabilized in five of the 10 patients at their last follow-up. No acute or late side effects of irradiation were noted.


CONCLUSIONS
Additional radiation therapy in selected patients with CNVMs who have failed to benefit from previous irradiation is well tolerated and appears to stabilize the disease process in a substantial proportion of these patients.
Department of Radiology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.
C S
CS
Cathcart
J N
JN
Halpern
C M
CM
Seery
A
A
Abdelsalam
M A
MA
Zarbin
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000175:diagnosis / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis / Q000532:radiotherapy*; D012008:Recurrence; D019233:Retreatment; D014792:Visual Acuity / Q000528:radiation effects