July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Microvascular abnormalities, retinal thickness changes and long-term efficacy after stereotactic radiotherapy under continued intravitreal anti-VEGF treatment for neovascular AMD
Author Affiliations & Notes
  • Katja Hatz
    Vista Klinik Binningen, Binningen, Basel-Land, Switzerland
    Vienna Reading Center, Department of Ophthalmology, Medical University Vienna, Austria
  • Frank Zimmermann
    Department of Radiation Oncology, University Hospital Basel, Switzerland
  • Emmanouil Lazaridis
    SWISS EyeRAD, Switzerland
  • Dimitrios Kardamakis
    Department of Radiation Oncology, Medical University Patras, Greece
  • Magdalena Guichard
    Vista Klinik Binningen, Binningen, Basel-Land, Switzerland
  • Cengiz Tuerksever
    Vista Klinik Binningen, Binningen, Basel-Land, Switzerland
  • Christian Pruente
    Eye clinic, University Hospital Basel, Switzerland
  • Ursula Schmidt-Erfurth
    Vienna Reading Center, Department of Ophthalmology, Medical University Vienna, Austria
  • Bianca S Gerendas
    Vienna Reading Center, Department of Ophthalmology, Medical University Vienna, Austria
  • Footnotes
    Commercial Relationships   Katja Hatz, Allergan AG (F), Bayer Switzerland AG (F), Kinarus (C), Novartis Switzerland AG (F); Frank Zimmermann, None; Emmanouil Lazaridis, None; Dimitrios Kardamakis, None; Magdalena Guichard, None; Cengiz Tuerksever, None; Christian Pruente, None; Ursula Schmidt-Erfurth, None; Bianca S Gerendas, None
  • Footnotes
    Support  Carl Zeiss Meditec AG supported this study in part.
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1154. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Katja Hatz, Frank Zimmermann, Emmanouil Lazaridis, Dimitrios Kardamakis, Magdalena Guichard, Cengiz Tuerksever, Christian Pruente, Ursula Schmidt-Erfurth, Bianca S Gerendas; Microvascular abnormalities, retinal thickness changes and long-term efficacy after stereotactic radiotherapy under continued intravitreal anti-VEGF treatment for neovascular AMD. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1154.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : To evaluate long-term efficacy and safety of adjunct stereotactic radiotherapy (SRT) to anti-VEGF injections in a treat-and-extend regimen (TER) in neovascular age-related macular degeneration (nAMD).

Methods : Clinical routine setting of 50 consecutive patients treated with a single session of SRT under continued TER with 3 year efficacy follow-up and reading center (Vienna Reading Center) based safety evaluation including standardized 7-field color fundus photography (CF), 7-field fluoresceine angiography plus peripheral imaging (FA) and Spectral-domain Optical coherence tomography (SD-OCT).

Results : After significant increase from baseline (4.24±0.66 weeks) to 12 months (7.52±3.05 weeks, p<0.001), mean maximum recurrence free treatment interval (RFTI) remained stable at 24 (7.40±3.17 weeks, p=0.746) and 36 months (6.89±3.00, p=0.175). 50% of eyes did not reach anymore their individual maximum RFTI at 36 months. Best corrected visual acuity (BCVA) remained stable during the first 12 months after SRT (p= 0.744), but decreased afterwards by -5.8±15.9 and -11.0±20.1 letters at 24 and 36 months, respectively. At the safety visit after 24±4 months 36% of SRT eyes showed microvascular abnormalities (MVA) on CF and/or FA most frequently located in the parafoveal inferior and nasal regions; in the inferior subfields accompanied by significant decreases of layer thicknesses at SD-OCT. The retinal nerve fiber layer was significantly decreased in the outer nasal subfield of central ETDRS grid representing parts of the papillomacular bundle (p= 0.0245). Peripheral fluoresceine angiography did not reveal any MVAs outside the standard ETDRS fields 1-7. However, there was no significant difference in mean BCVA change between eyes without and with MVAs at 24 and 36 months (-5.4 ±18.2 vs -6.4±11.4 letters, p=0.831; -9.7±19.2 vs -13.4±21.9 letters, p=0.545).

Conclusions : Due to MVAs in more than one third of patients, a significant decrease in retinal nerve fiber layer thickness in the papillomacular bundle and possibly weakening of the interval lengthening effect in parts of patients within year 3 after SRT a further close follow-up of all SRT patients is recommended.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×