Radiation therapy for neovascular age-related macular degeneration

Robert Petrarca, Timothy L JacksonDepartment of Ophthalmology, King&rsquo;s College Hospital NHS Foundation Trust, London, UKAbstract: Antivascular endothelial growth factor (anti-VEGF) therapies represent the standard of care for most patients presenting with neovascular (wet) age-related m...

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Autores principales:	Robert Petrarca, Timothy L Jackson
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d1b3a335b6674d5993fe2e4b4c3ff078
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spelling	oai:doaj.org-article:d1b3a335b6674d5993fe2e4b4c3ff0782021-12-02T07:26:49ZRadiation therapy for neovascular age-related macular degeneration1177-54671177-5483https://doaj.org/article/d1b3a335b6674d5993fe2e4b4c3ff0782011-01-01T00:00:00Zhttp://www.dovepress.com/radiation-therapy-for-neovascular-age-related-macular-degeneration-a6027https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Robert Petrarca, Timothy L JacksonDepartment of Ophthalmology, King&rsquo;s College Hospital NHS Foundation Trust, London, UKAbstract: Antivascular endothelial growth factor (anti-VEGF) therapies represent the standard of care for most patients presenting with neovascular (wet) age-related macular degeneration (neovascular AMD). Anti-VEGF drugs require repeated injections and impose a considerable burden of care, and not all patients respond. Radiation targets the proliferating cells that cause neovascular AMD, including fibroblastic, inflammatory, and endothelial cells. Two new neovascular AMD radiation treatments are being investigated: epimacular brachytherapy and stereotactic radiosurgery. Epimacular brachytherapy uses beta radiation, delivered to the lesion via a pars plana vitrectomy. Stereotactic radiosurgery uses low voltage X-rays in overlapping beams, directed onto the lesion. Feasibility data for epimacular brachytherapy show a greatly reduced need for anti-VEGF therapy, with a mean vision gain of 8.9 ETDRS letters at 12 months. Pivotal trials are underway (MERLOT, CABERNET). Preliminary stereotactic radiosurgery data suggest a mean vision gain of 8 to 10 ETDRS letters at 12 months. A large randomized sham controlled stereotactic radiosurgery feasibility study is underway (CLH002), with pivotal trials to follow. While it is too early to conclude on the safety and efficacy of epimacular brachytherapy and stereotactic radiosurgery, preliminary results are positive, and these suggest that radiation offers a more durable therapeutic effect than intraocular injections.Keywords: wet age-related macular degeneration, neovascular, radiation therapy, epimacular brachytherapy, stereotactic radiosurgery, anti-VEGF Robert PetrarcaTimothy L JacksonDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2011, Iss default, Pp 57-63 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Robert Petrarca Timothy L Jackson Radiation therapy for neovascular age-related macular degeneration
description	Robert Petrarca, Timothy L JacksonDepartment of Ophthalmology, King&rsquo;s College Hospital NHS Foundation Trust, London, UKAbstract: Antivascular endothelial growth factor (anti-VEGF) therapies represent the standard of care for most patients presenting with neovascular (wet) age-related macular degeneration (neovascular AMD). Anti-VEGF drugs require repeated injections and impose a considerable burden of care, and not all patients respond. Radiation targets the proliferating cells that cause neovascular AMD, including fibroblastic, inflammatory, and endothelial cells. Two new neovascular AMD radiation treatments are being investigated: epimacular brachytherapy and stereotactic radiosurgery. Epimacular brachytherapy uses beta radiation, delivered to the lesion via a pars plana vitrectomy. Stereotactic radiosurgery uses low voltage X-rays in overlapping beams, directed onto the lesion. Feasibility data for epimacular brachytherapy show a greatly reduced need for anti-VEGF therapy, with a mean vision gain of 8.9 ETDRS letters at 12 months. Pivotal trials are underway (MERLOT, CABERNET). Preliminary stereotactic radiosurgery data suggest a mean vision gain of 8 to 10 ETDRS letters at 12 months. A large randomized sham controlled stereotactic radiosurgery feasibility study is underway (CLH002), with pivotal trials to follow. While it is too early to conclude on the safety and efficacy of epimacular brachytherapy and stereotactic radiosurgery, preliminary results are positive, and these suggest that radiation offers a more durable therapeutic effect than intraocular injections.Keywords: wet age-related macular degeneration, neovascular, radiation therapy, epimacular brachytherapy, stereotactic radiosurgery, anti-VEGF
format	article
author	Robert Petrarca Timothy L Jackson
author_facet	Robert Petrarca Timothy L Jackson
author_sort	Robert Petrarca
title	Radiation therapy for neovascular age-related macular degeneration
title_short	Radiation therapy for neovascular age-related macular degeneration
title_full	Radiation therapy for neovascular age-related macular degeneration
title_fullStr	Radiation therapy for neovascular age-related macular degeneration
title_full_unstemmed	Radiation therapy for neovascular age-related macular degeneration
title_sort	radiation therapy for neovascular age-related macular degeneration
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/d1b3a335b6674d5993fe2e4b4c3ff078
work_keys_str_mv	AT robertpetrarca radiationtherapyforneovascularagerelatedmaculardegeneration AT timothyljackson radiationtherapyforneovascularagerelatedmaculardegeneration
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Radiation therapy for neovascular age-related macular degeneration

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