Radiation-associated choroidal neovasculopathy

Clinicopathological correlation of choroidal neovascularization after external beam radiotherapy in age-related macular degeneration

“…The visual prognosis of eyes with this particular manifestation, termed "radiation-associated choroidal neovasculopathy", is very poor in comparison to irradiated eyes without this complication [41]. A marked increase in exudation and subretinal bleeding is associated with the development of these so-called blebs [41]. Other authors [19,33,34] have reported similar findings, whereas such complications were not reported in several controlled studies [22,24,25,32,35,43].…”

“…Spaide, Leys et al [41] recognized an unusual pattern of new vessel growth, namely round or oval blebs along the outer border of the original neovascular lesion, in patients treated with external beam radiation. These lesions profusely leak fluorescein dye and are best visualized by indocyanine green angiography.…”

“…These lesions profusely leak fluorescein dye and are best visualized by indocyanine green angiography. Such lesions have been recognized in 7-12% of patients treated with 10-20 Gy after a follow-up of at least 1 year [41]. The visual prognosis of eyes with this particular manifestation, termed "radiation-associated choroidal neovasculopathy", is very poor in comparison to irradiated eyes without this complication [41].…”

“…Such lesions have been recognized in 7-12% of patients treated with 10-20 Gy after a follow-up of at least 1 year [41]. The visual prognosis of eyes with this particular manifestation, termed "radiation-associated choroidal neovasculopathy", is very poor in comparison to irradiated eyes without this complication [41]. A marked increase in exudation and subretinal bleeding is associated with the development of these so-called blebs [41].…”

Radiotherapy for age-related macular degeneration: no more pilot studies please

“…18 Since then a multitude of small pilot studies using standard fractions of 2-3 Gy with a total dose of 10-20 Gy have been published, some showing better maintenance of visual acuity in treated eyes, [11][12][13][14]19 while others failed to show any benefit. 15,[20][21][22] Overall, prior to the study by Hoeller et al there have been 10 randomised control trials (RCT), 15,[23][24][25][26][27][28][29][30]30,31 three nonrandomised trials 15,21,32 and eight case series each with over 100 people in the study 22,[33][34][35][36][37][38][39] (see Table 1). Among the above RCTs, three studies demonstrated a significant reduction in visual loss when comparing radiotherapy to very lowdose (effectively sham) radiotherapy 25 or observation.…”