Patient Perceptions and Experiences of Stereotactic Radiotherapy for Wet Age-Related Macular Degeneration

Senra, Hugo; Joseph, Sobha; Balaskas, Konstantinos; Horani, Mania; Aslam, Tariq

doi:10.5301/ejo.5000739

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…34 Patients expected fewer intravitreal injections and reported positive experiences of receiving SRT treatment. 35 Results of 1-year or 2-year data consistently supported that a reduction in injection frequency could significantly be reached in pretreated 16 17 36 and treatment-naïve nAMD 37 patients by adding a single session SRT to anti-VEGF standard therapy. However, as INTREPID was designed as a 2-year trial and already published real-life data only cover the first year, our analysis is the first evaluating treatment frequency in the third year.…”

Section: Discussionmentioning

confidence: 82%

Microvascular abnormalities and long-term efficacy after stereotactic radiotherapy under continued intravitreal anti-VEGF treatment for neovascular AMD

Hatz

Zimmermann

Lazaridis³

et al. 2020

Br J Ophthalmol

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BackgroundFor treatment of neovascular age-related macular degeneration (nAMD), multiple intravitreal injections of drugs targeting vascular endothelial growth factors (VEGF) result in a high burden for patients and healthcare systems. Low-energy stereotactic radiotherapy (SRT) might reduce the anti-VEGF need. This study evaluated the long-term efficacy and safety of adjunct SRT to anti-VEGF injections in a treat-and-extend regimen in nAMD.Methods50 consecutive patients were followed 3 years after single-session SRT, a safety analysis including standardised study imaging, and a reading centre based image analysis was performed after 2 years.ResultsAfter increase from baseline (4.24±0.66 weeks) to 12 months (7.52±3.05 weeks, p<0.001), mean recurrence-free anti-VEGF treatment interval remained stable at 24 (7.40±3.17, p=0.746) and 36 months (6.89±3.00, p=0.175). Mean visual acuity change was −5.8±15.9 and −11.0±20.1 letters at 24 and 36 months, respectively. 36% of eyes showed microvascular abnormalities (MVAs) on colour fundus photography and/or fluoresceine angiography most frequently located in parafoveal inferior and nasal regions.ConclusionIn real life, low-energy SRT was associated with a reduced anti-VEGF injection frequency through year 3. However, due to an observed visual acuity reduction and remarkable number of MVAs, a close follow-up of these patients is recommended. The real-life use, optimal treatment schedule and dose should be rediscussed critically.

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Section: Discussionmentioning

confidence: 82%

Microvascular abnormalities and long-term efficacy after stereotactic radiotherapy under continued intravitreal anti-VEGF treatment for neovascular AMD

Hatz

Zimmermann

Lazaridis³

et al. 2020

Br J Ophthalmol

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“…Es sollte auch bemerkt werden, dass wir keinen standardisierten Fragebogen wie den NEI-VFQ-25 oder EQ-5D verwendet haben, da wir einen eher kurzen, leicht verständlichen Fragebogen benötigten, den auch ältere Patienten zuhause ohne Hilfe oder Anweisungen eines Interviewers beantworten konnten [19]. Deshalb orientierten wir uns an der von Senra et al vorgeschlagenen SRT-spezifischen Abfrage, die bei einer Fallserie von 5 Patienten in Großbritannien angewendet wurde [12]. Damit ist der Fragebogen bei Weitem noch nicht etabliert, geschweige denn standardisiert, aber zumindest ein erster Schritt, um die Patientenzufriedenheit nach SRT evaluieren zu können.…”

Section: Diskussionunclassified

Patientenzufriedenheit nach stereotaktischer Radiotherapie bei exsudativer altersbedingter Makuladegeneration

Kurz

Rudolf

Holzhey

et al. 2017

Klin Monatsbl Augenheilkd

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Stereotactic radiotherapy (SRT) in conjunction with the common intravitreal injections (IVI) is a new adjuvant approach in neovascular age-related macular degeneration (AMD) patients. The aim of our study was to investigate factors influencing patient satisfaction one year after SRT. A questionnaire was administered to 35 AMD patients who had consecutively undergone SRT using the IRay-device at the Department of Ophthalmology, University of Lübeck. In addition to descriptive statistics, responses were evaluated by correlation analysis. Moreover, subgroup analyses were performed, using a classification of IVI responders (annual injection rate after SRT ≤ 3), visual acuity (VA) responders (VA improvement ≥ 0.2 logMAR) and double responders (annual injection rate after SRT ≤ 3 as well as VA improvement ≥ 0.2 logMAR). The response rate was 86%. With respect to their treatment expectations, twice as many patients hoped to receive less injections instead of a better vision. Those hoping for less injections were significantly more satisfied with their clinical outcome. In addition, IVI-responders were significantly more satisfied than IVI-non-responders, while VA-responders were not, compared to VA-non-responders. Patient satisfaction seems to depend on patients' comprehension of how SRT affects their disease and what kinds of expectations were set. It is of utmost importance to provide the patients with adequate and comprehensible education and to define realistic goals prior to SRT.

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Patient Perceptions and Experiences of Stereotactic Radiotherapy for Wet Age-Related Macular Degeneration

Abstract: Patients mainly justified their decision to receive Oraya treatment by expecting fewer intravitreal injections, but more research on this topic is needed to suggest new evidence-based treatment protocols for patients with wet ARMD.

Cited by 2 publications

References 7 publications

Microvascular abnormalities and long-term efficacy after stereotactic radiotherapy under continued intravitreal anti-VEGF treatment for neovascular AMD

Microvascular abnormalities and long-term efficacy after stereotactic radiotherapy under continued intravitreal anti-VEGF treatment for neovascular AMD

Patientenzufriedenheit nach stereotaktischer Radiotherapie bei exsudativer altersbedingter Makuladegeneration

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