Document Detail


Morphologic characteristics of disciform scarring after radiation treatment for age-related macular degeneration.
MedLine Citation:
PMID:  10889113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the influence of radiation therapy on the development of disciform lesions in patients with age-related macular degeneration (AMD). DESIGN: A prospective, nonrandomized, comparative trial (patient self-controlled). PARTICIPANTS: Forty eyes with exudative AMD involving the central fovea in 40 consecutive patients were enrolled in this study. INTERVENTION: Radiation was administered to the posterior pole with an 8-mV photon beam from a linear accelerator. A dose of 14.4 Gy, 1.8 Gy per day, five fractions per week was delivered through a single port. MAIN OUTCOME MEASURES: The visual acuity and the morphologic characteristics, demonstrated by fundus photography, fluorescein, and indocyanine green angiography, were investigated before treatment and every 3 months after treatment over a period of 24 months. In 10 patients with bilateral disease the disciform lesions were compared. RESULTS: Twenty five patients could be followed regularly over the period of 24 months. The disciform lesions occurring after radiation were classified in three types. Type I (10 patients) was characterized by being smaller than 2 DD in size, with little fibrotic tissue underneath the retina, but pronounced retinal pigment epithelial changes. Type II (seven patients) showed extensive growth of the choroidal neovascularization (CNV) extending to and beyond the arcades with angiographically active loops in the peripheral parts. Eight patients had type III lesions develop characterized by a size greater than 2 DD but fewer than 6 DD and by a different amount of fibrotic tissue, hemorrhage, and lipid. Type I scarring was significantly associated with occult CNV without pigment epithelial detachments, whereas type II scarring was associated with classic CNV at the initial presentation (P<0.05). CONCLUSIONS: Although no severe side effects have been reported after radiation therapy for AMD, a subgroup of patients may experience extensive growth of CNV after radiation, causing greater functional damage than occurs spontaneously.
Authors:
A Haas; U Prettenhofer; M Stur; R Hanselmayer; B Feigl; A Berghold; G Langmann; J Faulborn
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Ophthalmology     Volume:  107     ISSN:  0161-6420     ISO Abbreviation:  Ophthalmology     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-07-31     Completed Date:  2000-07-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1358-63     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Karl-Franzens-University, Graz, Austria.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Choroid / pathology,  radiation effects*
Choroidal Neovascularization / etiology,  pathology*
Female
Fluorescein Angiography
Fundus Oculi
Humans
Indocyanine Green / diagnostic use
Macular Degeneration / radiotherapy*
Male
Middle Aged
Prospective Studies
Radiation Injuries / etiology,  pathology*
Radiotherapy Dosage
Chemical
Reg. No./Substance:
3599-32-4/Indocyanine Green

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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