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M. Tokoro, T. Yasukawa, E. Sakurai, M. Yoshida, Y. Ogura; Long-Term Outcome of Radiation Therapy for Exudative Age-Related Macular Degeneration in Japanese Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):588.
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To evaluate long-term outcome of radiation therapy in eyes with exudative age-related macular degeneration (AMD) in Japanese patients.
Eighty eyes of 80 patients (54 men and 26 women) with exudative AMD, which underwent radiation therapy with 20 Gy (2 Gy per day for 10 days) between 1998 and 2003, were retrospectively reviewed. Averaged age and follow-up period were 69 +/- 8.1 years and 53 months, respectively. Visual outcome, additional therapies, complications were assessed. Visual improvement and worsening were defined as a change of 0.3 units or more in logarithm of minimum angle of resolution (logMAR) as preoperative and postoperative visual acuities were compared.
Mean duration to achieve the best postoperative visual acuity was 10 months. Visual acuity after the treatment was improved in 20 eyes (25.0%), stabilized in 56 eyes (70.0%), and deteriorated in 4 eyes (5.0%). However, the final visual acuity was deteriorated in 46 eyes (57.5%) as compared to the pre-treatment level. Only 9 eyes (11.3%) maintained the visual improvement until the final visit. Additional therapies were performed in 30 eyes (37.5%), including transpupillary thermal therapy (9 cases), surgical removal of choroidal neovascular membrane (8 cases), photodynamic therapy (7 cases), intravitreal injection of triamcinolone acetonide (3 cases), and laser photocoagulation (1 case). Massive subretinal hemorrhage was observed in 9 eyes (11.3%), which resulted in severe vision loss despite of additional vitrectomy.
Radiation therapy for exudative AMD achieved short-term efficacy but appeared less effective in long-term observation.
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