LOW-DOSE FRACTIONATED PERCUTANEOUS TELETHERAPY IN SUBFOVEAL CHOROIDALNEOVASCULAR MEMBRANES - CLINICAL-RESULTS

Aim: The effect of low-dose fractionated percutaneous teletherapy on v isual acuity and the changes in subfoveal neovascular membranes (SNM) in age-related macular degeneration (ARMD) were studied. Patients and methods: Forty-four patients (aged from 56 to 86 years) were treated. Best distant and near visual acuity was assessed before (initial visua l acuity; IVA) and 5 weeks, 3, 6 and 12 months after teletherapy. Fluo rescein angiography was done before and 3 and 12 months after radiatio n. Patients were divided into different groups by IVA for analysis. Me an follow-up was 9 months. Teletherapy was done by a 9 MeV linear acce lerator through a lateral port in the half-beam technique with a singl e dose of 2 Gy to a total dose of 20 Gy within 20 days. Results: No se vere negative side effects have been observed. Four patients reported epiphora. Visual acuity decreased one line in the group with an IVA of 0.05-0.2. The group with IVA 0.3-0.5 remained unchanged during the ob servation period. We found a tendency for increased visual acuity in g roup IVA greater than or equal to 0.6. Conclusions: Teletherapy seems to have an influence on visual acuity, SNM, and metamorphopsia. IV A a nd duration of thillness play important roles. We cannot say if there is a persistent effect, as these are preliminary results. The longest follow-up so far has been 12 months. In order to better evaluate the p otential of radiotherapy, this study must be pursued and coupled with further studies analyzing the effect on SNM in ARMD.