Document Detail


Strontium plaque irradiation of subfoveal neovascular membranes in age-related macular degeneration.
MedLine Citation:
PMID:  9457513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the effect of focal strontium-90 plaque radiotherapy on subfoveal choroidal neovascularization in patients with age-related macular degeneration. METHODS: Twenty patients with age-related macular degeneration, presenting with a recent subfoveal neovascular membrane, were treated with local episcleral radiotherapy using a strontium-90 applicator. The applicator was applied to the sclera under the macular region and held there tightly for 54 min to obtain a dose of 15 Gy at a depth of 1.75 mm. The main parameters evaluated at follow-up after 3, 6 and 12 months were visual acuity and changes in fluorescein angiography. Twelve untreated patients with the same criteria were followed as controls. RESULTS: Early effects of radiation could be seen at 3 months, but became more obvious after follow-up for 6 and 12 months. At 6 months, regression of the choroidal neovascularization was detected in 14/19 patients (74%) as a decrease in the size of the lesion or as diminished leakage in late-phase fluorescein angiography. Likewise, in 14/19 patients (74%) at 12 months the neovascular membrane was partially or totally occluded. In all patients showing regression of the choroidal neovascular membrane, the neurosensory detachment had also dried. Visual acuity was unchanged (within 1 line) or improved in 11/20 (55%) and 9/20 (45%) treated patients after 6 and 12 months, respectively. In the controls, the choroidal neovascularization had increased in size in 9/12 patients (75%) at the last follow-up (mean 12.0 months). Visual acuity was unchanged in 3/12 patients (25%). CONCLUSION: Local low-energy beta irradiation with a strontium-90 applicator can induce regression of choroidal neovascularization. The effect of irradiation is seen as a decrease in the size of the choroidal neovascular membrane and disappearance of the neurosensory detachment and exudates.
Authors:
A Jaakkola; J Heikkonen; P Tommila; L Laatikainen; I Immonen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie     Volume:  236     ISSN:  0721-832X     ISO Abbreviation:  Graefes Arch. Clin. Exp. Ophthalmol.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-31     Completed Date:  1998-03-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8205248     Medline TA:  Graefes Arch Clin Exp Ophthalmol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  24-30     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Helsinki University Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brachytherapy / instrumentation,  methods*
Choroid / blood supply*,  pathology,  radiation effects
Dose-Response Relationship, Radiation
Female
Fluorescein Angiography
Follow-Up Studies
Fovea Centralis
Fundus Oculi
Humans
Macular Degeneration / complications*
Male
Middle Aged
Neovascularization, Pathologic / etiology,  pathology,  radiotherapy*
Strontium Radioisotopes / therapeutic use*
Treatment Outcome
Visual Acuity
Chemical
Reg. No./Substance:
0/Strontium Radioisotopes

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