title: Proton beam irradiation for non-AMD CNV: 2-year results of a randomised clinical trial.
abstract: OBJECTIVE
  To evaluate safety and visual outcomes after proton beam irradiation (PBI) therapy for subfoveal choroidal neovascularisation (CNV) secondary to causes other than age-related macular degeneration (AMD).
  
  
  METHODS
  This study is a prospective, unmasked and randomised clinical trial using two dosage regimens, conducted in the Massachusetts Eye and Ear Infirmary. The study included 46 patients with CNV secondary to non-AMD and best-corrected visual acuity of 20/320 or better. Patients were randomly assigned to receive 16 or 24 cobalt gray equivalents (CGE) of PBI in two equal fractions. Complete ophthalmological examinations, fundus photography and fluorescein angiography were performed at baseline and 6, 12, 18 and 24 months after treatment.
  
  
  RESULTS
  At 1 year after treatment, 82% and 72% lost fewer than 1.5 lines of vision in the 16 CGE and in 24 CGE groups, respectively. At 2 years after therapy, 77% in the lower dose group and 64% in the higher dose group lost fewer than 1.5 lines of vision. Mild radiation complications such as radiation vasculopathy developed in 17.6% of patients.
  
  
  CONCLUSIONS
  PBI is a safe and efficacious treatment for subfoveal CNV not due to AMD. The data with respect to visual outcomes and radiation complications trend in favour of the 16 CGE group, although differences do not reach statistical significance. PBI may be considered as an alternative to current therapies.
authors.affiliation: Retina Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA Department of Ophthalmology, The University of Hong Kong, Hong Kong, China Department of Ophthalmology & Vision Science, Eye & ENT Hospital, Shanghai Medical School, Fudan University, Shanghai, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Chen
authors.affiliation: Retina Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ivana K
authors.initials: IK
authors.lastname: Kim
authors.affiliation: Retina Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lane
authors.affiliation: Retina Service, Ophthalmology Department, University of Montreal, Hôpital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Danny
authors.initials: D
authors.lastname: Gauthier
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Munzenrider
authors.affiliation: Retina Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Evangelos S
authors.initials: ES
authors.lastname: Gragoudas
authors.affiliation: Retina Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Joan W
authors.initials: JW
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020256:Choroidal Neovascularization / Q000209:etiology / Q000503:physiopathology / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D061766:Proton Therapy; D011522:Protons / Q000009:adverse effects; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D012164:Retinal Diseases / Q000209:etiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000528:radiation effects; D055815:Young Adult
chemical_list: D011522:Protons
keywords: Choroidal neovascularization; Clinical trial; Myopia; Proton Beam Irradiation