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[Low dosage, fractionated, percutaneous teletherapy of subfoveal choroid neovascularization]
M P Schittkowski1, H Schneider, P G Ziegler
1Universität-Augenklinik Rostock.
Aim:
The effect of low-dose fractionated percutaneous teletherapy on visual acuity and the changes in subfoveal neovascular membranes (SNM) in age-related macular degeneration (ARMD) were studied.
Patients And Methods:
Forty-four patients (aged from 56 to 86 years) were treated. Best distant and near visual acuity was assessed before (initial visual acuity; IVA) and 5 weeks, 3, 6 and 12 months after teletherapy. Fluorescein angiography was done before and 3 and 12 months after radiation. Patients were divided into different groups by IVA for analysis. Mean follow-up was 9 months. Teletherapy was done by a 9 MeV linear accelerator through a lateral port in the half-beam technique with a single dose of 2 Gy to a total dose of 20 Gy within 20 days.
Results:
No severe negative side effects have been observed. Four patients reported epiphora. Visual acuity decreased one line in the group with an IVA of 0.05-0.2. The group with IVA 0.3-0.5 remained unchanged during the observation period. We found a tendency for increased visual acuity in group IVA > or = 0.6.
Conclusions:
Teletherapy seems to have an influence on visual acuity, SNM, and metamorphopsia. IVA and duration of thillness play important roles. We cannot say if there is a persistent effect, as these are preliminary results. The longest follow-up so far has been 12 months. In order to better evaluate the potential of radiotherapy, this study must be pursued and coupled with further studies analyzing the effect on SNM in ARMD.