BACKGROUND: AMD is the leading cause of legal blindness in people aged of more than 50 in industrialized countries. Occult neovascularization accounts for more than 70% of all exsudatives forms of AMD. Radiotherapy has been proposed as a possible treatment for retrofoveal neovascularization. We present the first results of a pilot study actually ongoing at the AMD Center in Creteil. PATIENTS AND METHODS: 44 patients (46 eyes) presenting occult choroidal neovascularization involving the fovea, aged of > 50 years and with a minimal visual acuity of at least 0.1 were included. They received a total dose of 16 Gy in 4 sessions of 4 Gy. All the patients were checked after 3 months. RESULTS: Visual acuity was globally maintained (> 0.1 in 93% of the eyes). Only one eye suffered a significant loss of vision (> 6 lines) and 11% suffered a moderate loss of vision (> 3 lines). Moreover 67% of eyes still had a near vision of 0.5 or more with reading glasses. On fluorescein angiography 17.5% of the eyes experienced an increase of the size of the occult neovascularization of > 0.5 Disk Area (DA), 76% showed no modification and 6.5% demonstrated a decrease in size of > 0.5 DA. CONCLUSIONS: As it has been shown that the antimitotic action of radiotherapy is most effective after 3 months, the present results suggest better evolution than natural history. However, as occult choroidal neovascularization is a slow-evolving disease further follow-up is needed to confirm it.
BACKGROUND:AMD is the leading cause of legal blindness in people aged of more than 50 in industrialized countries. Occult neovascularization accounts for more than 70% of all exsudatives forms of AMD. Radiotherapy has been proposed as a possible treatment for retrofoveal neovascularization. We present the first results of a pilot study actually ongoing at the AMD Center in Creteil. PATIENTS AND METHODS: 44 patients (46 eyes) presenting occult choroidal neovascularization involving the fovea, aged of > 50 years and with a minimal visual acuity of at least 0.1 were included. They received a total dose of 16 Gy in 4 sessions of 4 Gy. All the patients were checked after 3 months. RESULTS: Visual acuity was globally maintained (> 0.1 in 93% of the eyes). Only one eye suffered a significant loss of vision (> 6 lines) and 11% suffered a moderate loss of vision (> 3 lines). Moreover 67% of eyes still had a near vision of 0.5 or more with reading glasses. On fluorescein angiography 17.5% of the eyes experienced an increase of the size of the occult neovascularization of > 0.5 Disk Area (DA), 76% showed no modification and 6.5% demonstrated a decrease in size of > 0.5 DA. CONCLUSIONS: As it has been shown that the antimitotic action of radiotherapy is most effective after 3 months, the present results suggest better evolution than natural history. However, as occult choroidal neovascularization is a slow-evolving disease further follow-up is needed to confirm it.