CHOROIDAL NEOVASCULAR MEMBRANES - TREATMENT WITH REIRRADIATION

PURPOSE: To evaluate re-treatment with an additional course of low-dos e irradiation in patients with progressive or recurrent choroidal neov ascular membranes (CNVMs). MATERIALS AND METHODS: Ten patients who had received 14 Gy of external-beam radiation therapy in seven fractions for subfoveal CNVMs were found to have recurrent or persistent neovasc ularization at follow-up. They received an additional 15 Gy of radiati on therapy administered in five daily fractions with a standard lens-s paring technique. Before reirradiation, visual acuity ranged from 20/8 0 to counting fingers. The median time between radiation courses was 6 .5 months (range, 2-16 months). After re-treatment, the patients were followed up with angiography and visual field testing. The median foll ow-up was 18.5 months (range, 12-21 months). RESULTS: Eight of 10 pati ents (80%) maintained their visual acuity at 1 year nad three of seven (43%) at 18 months. Visual acuity was stabilized in five of the 10 pa tients at their last follow-up. No acute or late side effects or irrad iation were noted. CONCLUSION: Additional radiation therapy in selecte d patients with CNVMs who have failed to benefit from previous irradia tion is well tolerated and appears to stabilize the disease process in a substantial proportion of these patients.