Long-term results after external radiotherapy in age-related macular degeneration. A prospective study.
OBJECTIVE
To prospectively evaluate the short- and long-term efficacy of external radiotherapy (RT) in patients with age-related macular degeneration (AMD) by comparing two different dose schedules.


METHODS
In this prospective, nonrandomized, comparative study including 80 patients, the efficacy of external RT with a total dose of 14.4 Gy (group A, n = 40) and 25.2 Gy (group B, n = 40) was compared. Patients of group A were irradiated between September 1995 and July 1996, patients of group B between August 1996 and November 1997. 67 patients presented with occult choroidal neovascularization (CNV), 13 with classic subfoveal lesions. Complete ophthalmologic investigation was performed before RT, at intervals of 3 months during the 1st year after RT, and of 6 months thereafter.


RESULTS
12 months after RT, vision deteriorated in 85% (14.4 Gy) and 65% (25.2 Gy) of patients. Central visual field decreased with both dose schedules. There was no morphological benefit in neovascular changes. After 48 months, complete follow-up was possible in 46 patients who showed a significant loss of vision similar to the natural course of AMD.


CONCLUSIONS
External RT of AMD with 14.4 Gy as well as with the escalated dose of 25.2 Gy showed a poor beneficial outcome after 6 and 12 months, respectively. After a follow-up of 4 years, visual outcome in irradiated patients was similar to the natural course of the disease. A conspicuous efficacy of RT in prevention of blindness could not be demonstrated.
Prettenhofer
Ulrike
U
Department of Radiotherapy, University Medical School, Graz, Austria. ulrike.prettenhofer@uni-graz.at
Haas
Anton
A
Mayer
Ramona
R
Stranzl
Heidi
H
Oechs
Astrid
A
Hackl
Arnulf
A
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D014792:Visual Acuity / Q000528:radiation effects; D014794:Visual Fields / Q000528:radiation effects