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Radiation therapy for subretinal neovascularization

P T Finger1, A Berson, D Sherr

  • 1Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, USA.

Ophthalmology
|June 1, 1996
PubMed
Summary
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Low-dose radiation therapy, including external beam irradiation and plaque brachytherapy, can reduce subretinal neovascularization. Plaque brachytherapy delivered a higher dose to neovascular tissue with less radiation to surrounding structures.

Area of Science:

  • Ophthalmology
  • Radiation Oncology
  • Medical Physics

Background:

  • Subretinal neovascularization, often associated with exudative age-related macular degeneration, presents challenges for vision preservation.
  • Traditional treatments like laser photocoagulation have shown limited success and can lead to poor visual outcomes.

Purpose of the Study:

  • To evaluate the efficacy and dose distribution of low-dose external beam irradiation and plaque radiotherapy for treating subretinal neovascularization.
  • To compare radiation dose delivery to ocular and intracranial structures between the two radiotherapy modalities.

Main Methods:

  • A cohort of 75 patients with exudative age-related macular degeneration received external beam irradiation (1200-1500 cGy).
  • Six patients were treated with palladium-103 ophthalmic plaque brachytherapy to an equivalent dose of 1200-1500 cGy.

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  • Radiation dose distributions were analyzed, and visual acuity, ophthalmic examinations, and angiography were performed pre- and post-treatment.

    • Main Results:

    • Episcleral plaque brachytherapy delivered a higher radiation dose to neovascular tissues compared to external beam irradiation.
    • Both radiotherapy methods reduced hemorrhages, exudates, and neovascular membrane leakage.
    • External beam radiotherapy resulted in transient epiphora and ocular irritation in 13% of patients.

    Conclusions:

    • Low-dose radiotherapy presents a promising approach for treating subretinal neovascularization, potentially preserving overlying retinal tissue.
    • Plaque radiotherapy demonstrated advantages in dose distribution, targeting neovascular tissue while sparing normal ocular and intracranial structures.
    • Further investigation is needed to compare the relative efficacy, cost, convenience, and safety of different radiotherapy techniques.