Radiation therapy of occult choroidal neovascularisation (CNV) in age-related macular degeneration (AMD)

Background Occult choroidal neovascularisation secondary to age-related mac ular degeneration cause severe visual loss due to exsudation, hemorrhage an d fibrovascular scarring. So far, no efficient treatment of this condition could be established. Recently, some publications described an improved pro gnosis after low-dose radiation therapy of the neovascular membranes. Patients and methods Patients with occult choroidal neovascularisation as d efined by the Macular Photocoagulation Study were inclosed in our study. Ir radiation with Photons (10 to 12 MeV) in fractions of 5x2 Gy were administe red. At three-month follow-up intervals visual acuity a complete ophthalmol ogical examination including visual acuity, fluorescein- and ICG-angiograph y as well as fundus photography was performed. Results In our study 64 patients (74 +/- 7 years) with occult CNV secondary to AMD were included. Follow-up was between 3 and 39 months (14.5 +/- 10). Compared to studies who investigated the natural history of this disease, the Visual acuity measured in our study did not differ significantly from t he natural course. Conclusions Our results do not support the general use of radiation therapy in patients with occult choroidal neovascularisation secondary to AMD. How ever, the controlled multicenter studies might provide a better basis for a general recommendations.