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Stereotactic radiotherapy for polypoidal choroidal vasculopathy: a pilot study.

Ugo Introini1, Giuseppe Casalino, Giacinto Triolo

  • 1Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.

Ophthalmologica. Journal International D'Ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde
|November 18, 2014
PubMed
Summary

Low-voltage X-ray stereotactic radiotherapy (SRT) combined with ranibizumab shows promise for treating polypoidal choroidal vasculopathy (PCV). This therapy led to polyp regression, reduced central foveal thickness, and improved visual acuity with no reported adverse events.

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Area of Science:

  • Ophthalmology
  • Radiation Oncology
  • Medical Imaging

Background:

  • Macular polypoidal choroidal vasculopathy (PCV) is a significant cause of vision loss.
  • Current treatments for PCV have limitations, necessitating novel therapeutic approaches.

Purpose of the Study:

  • To assess the safety and efficacy of low-voltage X-ray stereotactic radiotherapy (SRT) combined with intravitreal ranibizumab for active macular PCV.

Main Methods:

  • Patients received an initial intravitreal ranibizumab injection followed by 16-Gy X-ray SRT to the macula.
  • Subsequent ranibizumab injections were administered as needed (pro re nata).
  • Polyp regression via indocyanine green angiography, best-corrected visual acuity (BCVA), and central foveal thickness (CFT) via optical coherence tomography were primary and secondary outcome measures.

Main Results:

  • In 12 patients, 10 showed angiographic polyp regression at 12 months.
  • Mean BCVA improved by 7.6 ETDRS letters.
  • Mean CFT significantly decreased (p < 0.01) from 372.3 ± 79.6 µm to 215.9 ± 57.9 µm.
  • No adverse events were reported.

Conclusions:

  • Low-voltage X-ray SRT combined with ranibizumab appears safe for treating macular PCV.
  • The treatment demonstrated polyp closure, reduced CFT, and improved BCVA.
  • Further research is needed to confirm long-term efficacy and safety.