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MIAMI — In previously treated wet age-related macular degeneration, low-voltage X-ray irradiation may increase the durability of a ranibizumab treatment regimen, a speaker said here.
In a study led by Darius M. Moshfeghi, MD, 19 patients were given a single treatment of noninvasive, externally delivered low-voltage X-ray irradiation. The 24-Gy dose was administered to patients with neovascular AMD who had been previously treated with intravitreal Lucentis (ranibizumab, Genentech).
Single-dose X-ray irradiation paired with intravitreal ranibizumab works especially well for patients who have fluid at baseline, have a greatest linear dimension of less than 4 mm, and who have minimal fibrosis, Moshfeghi said at Angiogenesis, Exudation, and Degeneration 2013.
The two modern radiation therapies are stereotactic X-ray irradiation and epimacular brachytherapy. According to Moshfeghi, stereotactic uses a robotic control system vs. a manual control, uses ocular tracking, is noninvasive vs. surgical, has a greater horizontal dose control, and has less vertical dosing stability.
Radiation therapy coupled with intravitreal ranibizumab also maintains visual acuity and decreases the amount of fluid seen on optical coherence tomography, Moshfeghi said.
Disclosure: Moshfeghi is a consultant for Oraya Therapeutics, Synergetics, Krypton Vision and Visunex Medical Systems, is on the advisory board for Genentech and Regeneron, and is part equity owner of Oraya Therapeutics, InSitu Therapeutics, Krypton Vision, Visunex Medical Systems, Convene LLC and Versavision LLC.
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