Radiotherapy of exudative age-related macular degeneration; a clinical and pathologic study.
BACKGROUND
Radiotherapy has recently been employed to treat patients with exudative macular degeneration in order to prevent severe visual loss. Radiotherapy affects the evolution of exudative macular degeneration directly by endothelial toxicity, leading to capillary closure, and/or indirectly through its attenuating effects on the inflammatory response, mediated by macrophages and other inflammatory cells.


METHODS
In this study we describe the histopathologic findings in a patient with exudative age-related macular degeneration (AMD) in both eyes whose right eye was treated with radiotherapy (5 times 2 Gy) 3 years before he died. The eyes were enucleated post mortem and investigated by light microscopy. Additionally, immunohistochemical investigation with antibodies against CD34 and CD68 was performed to identify patent endothelial cells and macrophages.


RESULTS
Both eyes showed neovascular AMD consisting of mixed fibrocellular and fibrovascular membranes. Capillaries in both the choriocapillaris and the neovascular membrane were patent in both eyes. Macrophages were present in the choroidal neovascularization of both eyes. Neither preexistent choroidal, intraretinal, nor neovascular vessels showed increased wall thickness as sign of radiation damage.


CONCLUSIONS
No radiation-related histopathologic effect could be demonstrated 3 years after radiation therapy in this patient with AMD.
Lambooij
A C
AC
Department of Ophthalmology, Erasmus University Rotterdam, The Netherlands. lambooij@gen.fgg.eur.nl
Kuijpers
R W
RW
Mooy
C M
CM
Kliffen
M
M
D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D002829:Choroid / Q000098:blood supply; D020256:Choroidal Neovascularization / Q000473:pathology; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology; D005122:Exudates and Transudates; D006801:Humans; D007124:Immunoenzyme Techniques; D008264:Macrophages / Q000378:metabolism / Q000473:pathology; D008268:Macular Degeneration / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D011874:Radiometry; D012171:Retinal Vessels / Q000473:pathology; D000097382:CD68 Molecule
D015703:Antigens, CD; D018952:Antigens, CD34; D015214:Antigens, Differentiation, Myelomonocytic; C067980:CD68 antigen, human; D000097382:CD68 Molecule