TELETHERAPY FOR SUBFOVEAL CHOROIDAL NEOVASCULARIZATION OF AGE-RELATEDMACULAR DEGENERATION - RESULTS OF FOLLOW-UP IN A NONRANDOMIZED STUDY

Aim - A preliminary report indicated stable or improved vision in 12 o f 19 patients with subfoveal choroidal neovascularisation treated with 12 or 15 Gy of 6 IMV photons to the affected macula after an average follow up of 18 months. Here the prolonged follow up findings in this group of treated patients is reported which was further increased to 4 1. Methods - Forty one patients with subfoveal choroidal neovascularis ation were treated with 10, 12, or 15 Gy of 6 IMV photons to the macul a of the affected eye. Thirteen eyes of It patients were also observed as a non-randomised comparison group. Results - At It, 18, and 24 mon ths of follow up the mean change in visual acuity in eyes treated with radiotherapy was less than 1 Bailey-Lovie line from that measured at presentation. By contrast, the eyes in the comparison group lost 3.7 l ines of acuity at 12 months which increased to 4.5 at 24 months. These differences were highly significant at each of the time points. When initial visual acuity was taken into account, treated eyes lost on ave rage 12% of baseline acuity throughout follow up, whereas eyes belongi ng to the untreated group lost 50% of baseline acuity at I year, and 7 5% at 2 years. There was no significant difference in visual outcome b etween the three dose regimens used, which may simply be a reflection of the small sample size in each group. There was no evidence of radia tion induced retinopathy or optic neuropathy in any treated patients. Conclusions - Teletherapy appeared to have a treatment effect in eyes with subfoveal choroidal neovascularisation resulting in maintained vi sual function without significant radiation induced morbidity.