title: Radiation therapy for neovascular age-related macular degeneration.
abstract: In the enormity of the public health burden imposed by age-related macular degeneration (ARMD), much effort has been directed toward identifying effective and efficient treatments. Currently, anti-vascular endothelial growth factor (VEGF) injections have demonstrated considerably efficacy in treating neovascular ARMD, but patients require frequent treatment to fully benefit. Here, we review the rationale and evidence for radiation therapy of ARMD. The results of early photon external beam radiation therapy are included to provide a framework for the sequential discussion of evidence for the usage of stereotactic radiation therapy, proton therapy, and brachytherapy. The evidence suggests that these 3 modern modalities can provide a dose-dependent benefit in the treatment of ARMD. Most importantly, preliminary data suggest that all 3 can be used in conjunction with anti-VEGF therapeutics, thereby reducing the frequency of anti-VEGF injections required to maintain visual acuity.
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Amar U
authors.initials: AU
authors.lastname: Kishan
authors.forename: Bobeck S
authors.initials: BS
authors.lastname: Modjtahedi
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Morse
authors.forename: Percy
authors.initials: P
authors.lastname: Lee
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D017785:Photons / Q000627:therapeutic use; D061766:Proton Therapy / Q000379:methods; D016634:Radiosurgery / Q000379:methods; D012160:Retina / Q000528:radiation effects; D012164:Retinal Diseases / Q000209:etiology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A