title: 24-Gy low-voltage x-ray irradiation with ranibizumab therapy for neovascular AMD: 6-month safety and functional outcomes.
abstract: OBJECTIVE
  To describe the 6-month safety and preliminary efficacy outcomes of the use of 24-Gy radiation with intravitreal ranibizumab for patients with neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  A single treatment of a non-invasive, externally delivered low-voltage x-ray irradiation at a dose of 24 Gy was administered in one session through three locations in the inferior pars plana in a consecutive series of patients with neo-vascular AMD (treatment naïve and previously treated). Optical coherence tomography (OCT) and Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity examinations were performed at 1 week, 1 month, and monthly thereafter with quarterly fluorescein angiography.
  
  
  RESULTS
  Nineteen patients completed 6 months of follow-up. There was no evidence of radiation retinopathy, optic neuropathy, or cataract. The mean baseline ETDRS score was 38.3 ± 19.5 letters. At 6 months, the corresponding ETDRS score was 44.7 ± 16.8 letters. At 6 months, the mean change in visual acuity was 6.4 ± 9.8 ETDRS letters. Patients received an average of 0.4 additional ranibizumab injections following the initial two mandated injections.
  
  
  CONCLUSIONS
  A single treatment of external 24-Gy low-voltage x-ray therapy in conjunction with ranibizumab demonstrated an overall improvement in visual acuity in patients with neovascular AMD at 6 months, with no radiation-related adverse effects.
authors.affiliation: Associacion Para Evitar La Ceguera En Mexico, Mexico City, Mexico.
authors.forename: Virgilio Morales
authors.initials: VM
authors.lastname: Canton
authors.forename: Hugo
authors.initials: H
authors.lastname: Quiroz-Mercado
authors.forename: Raul
authors.initials: R
authors.lastname: Velez-Montoya
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Lopez-Miranda
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Moshfeghi
authors.forename: Eugene M
authors.initials: EM
authors.lastname: Shusterman
authors.forename: Peter K
authors.initials: PK
authors.lastname: Kaiser
authors.forename: Steven R
authors.initials: SR
authors.lastname: Sanislo
authors.forename: Michael
authors.initials: M
authors.lastname: Gertner
authors.forename: Darius M
authors.initials: DM
authors.lastname: Moshfeghi
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008875:Middle Aged; D011879:Radiotherapy Dosage; D000069579:Ranibizumab; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology / Q000532:radiotherapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab