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Noninvasive radiotherapy reduces need for repeated anti-VEGF injections in AMD patients, study shows
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MILAN — One-year results of the INTREPID study of stereotactic radiotherapy in neovascular age-related macular degeneration showed viability of this treatment modality, according to a retina specialist.
External beam radiotherapy previously obtained minimal functional benefits in AMD, as low doses of radiation were used to avoid inducing optic neuropathy or retinopathy.
Timothy L. Jackson
"New devices, like the Oraya IRay, target directly on the macula, minimizing the involvement of non-targeted areas," Timothy L. Jackson, PhD, FRCOphth, said at the Euretina congress.
In the INTREPID study, radiotherapy was used in patients who had been treated with at least three anti-VEGF injections in the previous year. A total of 230 patients were divided into three groups that received a radiation dose of 16 Gy, 24 Gy or sham exposure. Patients were followed monthly and re-treated with anti-VEGF injections if needed.
"The need for further intravitreal injections was reduced by 30% and 35% in the two radiotherapy groups compared to previous years. Patients in the active arms were two times more likely to receive no injection over the course of the year and approximately half as likely to need four or more injections over the course of the year," Jackson said. "No loss of visual acuity was reported, and OCT showed twice the reduction of central subfoveal thickness compared to controls. No radiation retinopathy or other [serious adverse events] were reported in the study eye."
Subgroup analysis of best responders showed that patients with small active lesions and no fibrosis had the greatest increase in best corrected visual acuity, with a tendency to gain letters.