PROSPECTIVE CONTROLLED EVALUATION ON RADIOTHERAPY OF SUBFOVEOLAR NEOVASCULARIZATION

Despite the successful thera py of sub retinal neovascular membranes b y laserphotocoagulation there are many problems to be overcome. In the case of subfoveolar neovascularization, photocoagulation leads to a s udden decrease in visual acuity. Recently radiotherapy is considered a s an alternative. Complications and effectivity were evaluated in this prospective and randomized trial. The initial results are presented. Patients and methods: There a re 76 patients (51 women, 25 men, averag e age 77.7 +/- 8.6 years) included in the prospective randomized study . All of them show subfoveolar neovascular membranes in FLA and a decr ease in visual acuity between 0.05 and 0.5. They were randomly assigne d to either the radiotherapy or the control group. Radiotherapy was do ne within 6 days by 6 x 2 Gy (6 MV photons). The follow-up was at 4 we eks, after 3 months, after 6 months and then every 6 months after the end of radiotherapy. On average the follow-up is at 15.1 months. Resul ts: Concerning age and Visual acuity before thera py, the control grou p and the radiotherapy group were not significantly different. At 4 we eks after radiotherapy, visual acuity was 0.13 +/- 0.46 (LogMAR). Afte r 12 months, visual acuity at a distance was 0.11 +/- 0.30 in the ther apy group and 0.09 +/- 0.13 (P = 0.838) in the control group. Patients with a preoperative Visual acuity better than 0.2 improved more after radiotherapy. Metamorphopsy improved in 75 % of the therapy group. Th e following complications could be observed: In the control group 3 pa tients suffered subretinal bleeding, in the radiotherapy group 3 patie nts, respectively. Conclusions: At present, the follow-up is too short to recommend radiotherapy as a standard procedure in the case of subf oveolar neovascularization. The results in patients with a better preo perative Visual acuity encourage us to continue this study.