External beam irradiation of subfoveal choroidal neovascularization complicating age-related macular degeneration

One-year results of a prospective, double-masked, randomized clinical trial

D. M. Marcus, W. C. Sheils, M. H. Johnson, S. B. McIntosh, D. B. Leibach, A. Maguire, J. Alexander, C. N. Samy

Research output: Contribution to journalArticle

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Abstract

Objectives: To determine the effects of low-dose external beam irradiation compared with observation on the visual function of eyes with subfoveal choroidal neovascularization (CNV) complicating age-related macular degeneration (ARMD). Design: Prospective, double-masked, randomized clinical trial. Patients randomized to the radiation group received external beam irradiation at a dose of 14 Gy in 7 fractions of 2 Gy. Patients randomized to the observation group received sham radiation. Setting: Tertiary care retinal referral practice. Patients: Individuals with classic, mixed, or occult subfoveal CNV secondary to ARMD. Main Outcome Measures: Change in visual acuity from baseline to specified time periods. Secondary outcome variables were contrast sensitivity and fundus photographic/fluorescein angiographic progression. Results: Forty-two eyes were randomized to observation; 41 eyes, to radiation. Baseline characteristics and demographics did not differ between groups. The median distance visual acuity (DVA) in radiation-treated eyes decreased from 20/80 at baseline to 20/320 (mean loss rate, 4.14 lines) at 1-year follow-up. The median DVA in observation group eyes decreased from 20/125 at baseline to 20/250 (mean loss rate, 3.39 lines) at 1-year follow-up. There were no statistically significant differences in changes in DVA, contrast sensitivity, or fluorescein angiographic progression from baseline between groups at any follow-up period. Conclusions: At 1-year follow-up, low-dose external beam irradiation at 14 Gy in 7 fractions of 2 Gy is neither beneficial nor harmful for subfoveal CNV complicating ARMD.

Original languageEnglish (US)
Pages (from-to)171-180
Number of pages10
JournalArchives of Ophthalmology
Volume119
Issue number2
StatePublished - Feb 22 2001

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Choroidal Neovascularization
Macular Degeneration
Randomized Controlled Trials
Visual Acuity
Radiation
Contrast Sensitivity
Observation
Fluorescein
Tertiary Healthcare
Referral and Consultation
Demography
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

External beam irradiation of subfoveal choroidal neovascularization complicating age-related macular degeneration : One-year results of a prospective, double-masked, randomized clinical trial. / Marcus, D. M.; Sheils, W. C.; Johnson, M. H.; McIntosh, S. B.; Leibach, D. B.; Maguire, A.; Alexander, J.; Samy, C. N.

In: Archives of Ophthalmology, Vol. 119, No. 2, 22.02.2001, p. 171-180.

Research output: Contribution to journalArticle

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abstract = "Objectives: To determine the effects of low-dose external beam irradiation compared with observation on the visual function of eyes with subfoveal choroidal neovascularization (CNV) complicating age-related macular degeneration (ARMD). Design: Prospective, double-masked, randomized clinical trial. Patients randomized to the radiation group received external beam irradiation at a dose of 14 Gy in 7 fractions of 2 Gy. Patients randomized to the observation group received sham radiation. Setting: Tertiary care retinal referral practice. Patients: Individuals with classic, mixed, or occult subfoveal CNV secondary to ARMD. Main Outcome Measures: Change in visual acuity from baseline to specified time periods. Secondary outcome variables were contrast sensitivity and fundus photographic/fluorescein angiographic progression. Results: Forty-two eyes were randomized to observation; 41 eyes, to radiation. Baseline characteristics and demographics did not differ between groups. The median distance visual acuity (DVA) in radiation-treated eyes decreased from 20/80 at baseline to 20/320 (mean loss rate, 4.14 lines) at 1-year follow-up. The median DVA in observation group eyes decreased from 20/125 at baseline to 20/250 (mean loss rate, 3.39 lines) at 1-year follow-up. There were no statistically significant differences in changes in DVA, contrast sensitivity, or fluorescein angiographic progression from baseline between groups at any follow-up period. Conclusions: At 1-year follow-up, low-dose external beam irradiation at 14 Gy in 7 fractions of 2 Gy is neither beneficial nor harmful for subfoveal CNV complicating ARMD.",
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