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Robert Petrarca, Matthew Richardson, Jeffrey A. Nau, Timothy L. Jackson; Safety Testing of Epimacular Brachytherapy using Microperimetry. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1680.
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To test retinal sensitivity in patients undergoing epimacular brachytherapy for previously treated neovascular age-related macular degeneration (nAMD).
A prospective study of 12 subjects enrolled on the MERITAGE study at one UK site. At baseline, subjects underwent pars plana vitrectomy and 24 Gray epimacular brachytherapy using a Strontium-90 source (NeoVista, Newark, CA). Patients received ranibizumab therapy monthly if predefined retreatment criteria were met. Microperimetry (MP-1; Nidek Technologies, Padova, Italy) was performed pre-operatively and at month 12.
Mean age was 75 (SD 8) years. ETDRS VA remained stable over 12 months (-0.33 letters; SD 13.2; P=0.932) with a mean of 3.5 ranibizumab injections, including those given at baseline for pre-existing disease activity. Both mean sensitivity (MS) and mean defect improved slightly by 0.79 dB (SD, 3.92 dB; P=0.499) and 1.71 dB (SD, 4.26 dB; P=0.192) respectively. The increase in MS was evident both within the treated lesions (0.88 dB; SD 3.17; P=0.357), and in neighbouring unaffected retina (0.65 dB; SD 4.23; P=0.606), as defined using fluorescein angiography and fundus photographs. Fixation stability and location were unaffected.
The fact that retinal sensitivity remained stable in areas not visibly affected by nAMD suggests that epimacular brachytherapy does not produce a deleterious effect in healthy retina.
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