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Minimally invasive radiation therapy shows encouraging results in AMD
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HAMBURG — A new device for episcleral brachytherapy showed safety and tolerability in patients with neovascular AMD, according to the results of a phase I trial presented at the Euretina meeting.
“Combined with anti-VEGF injections, it may result in synergy and reduced treatment burden. An increased proportion of patient may respond to treatment and preserve vision,” Kam Balaggan, MD, said.
The device, produced by Salutaris Medical Devices, allows for minimally invasive delivery of radiation. It consists of a curved cannula with a fibrotic light at the tip attached to a reservoir of radioactive seeds and a flexible cable with an internal plunger. The cannula is passed through a tenon incision between the extraocular muscles towards the macula and gently held in place over the center of the choroidal neovascularization.
“The retina is visualized with transillumination from the light tip and once the correct position is achieved, the plunger is depressed to deliver the radioactive seeds to the tip, which is held there for 5 minutes. The probe is then removed,” Balaggan explained.
In a study, 6 patients received 24Gy radiation over 5.5 minutes directly to the macular CNV using the brachytherapy device. Patients also received concomitant anti-VEGF injections with further readministration as needed.
“The procedure was well tolerated with no serious side effects. All patients experienced increased BCVA, and 2 of them did not require further anti-VEGF injections,” Ballagan said. “Reduced macular thickness was visible by OCT in all cases.”
The procedure is performed in an outpatient setting under local anesthesia and lasts approximately 15 minutes with minimal patient discomfort.
Disclosure: Balaggan is scientific advisor for Salutaris Medical Devices but receives no honorarium.