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document
[ Radiotherapy for choroidal neovascularization in age-related macular degeneration . A pilot study using low- versus high-dose photon bean radiation ] . PURPOSE Several pilot studies have indicated that low-dose radiation therapy might have a beneficial effect on the course of choroidal neovascularization ( CNV ) in age-related macular degeneration ( AMD ) . This study aimed to ascertain whether such treatment might halt the progression of neovascular AMD and whether a low or a high radiation dose should be applied . PATIENTS The patients comprised some randomized to 0 vs 10 vs 36 Gy of radiation and ( after a change of the study protocol became necessary ) others who participated in a prospective , controlled non-randomized pilot study . Enclosed were eyes with visual acuity of > or = 0.1 and < or = 0.6 revealing a juxta-subfoveal CNV either of the occult type ( type 1 ) or the classic type ( isolated or as part of a predominantly occult lesion ) . RESULTS Eyes treated with 10 Gy for occult CNV ( n = 12 ) were subject to severe visual loss in 41.6 % of the cases compared to 38.5 % in the control group ( n = 13 ) at 12 months of follow-up . For eyes treated with 10 Gy because of classic CNV , the corresponding figures were 33 % ( n = 18 ) and 57 % ( n = 14 ) respectively . At 18 months of follow-up , the percentages were 63 % and 75 % respectively . Fluorescein angiographic growth of classic and occult CNV could not be halted by 10 Gy , while a temporary growth retardation was observed in cases irradiated with 36 Gy . CONCLUSION In the study presented , the natural course of occult CNV could not be improved by irradiation with 10 or 36 Gy . In cases of classic CNV , low-dose irradiation with 10 Gy postponed severe visual loss by a maximum of 18 months . A positive treatment effect was also observed in cases irradiated with 36 Gy ; however , a 25 % incidence of radiation retinopathy seems unacceptable .
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Intervention_Physical
Radiotherapy
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Intervention_Physical
low- versus high-dose photon bean radiation
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Intervention_Physical
low-dose radiation therapy
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Intervention_Physical
0 vs 10 vs 36 Gy of radiation
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Intervention_Physical
10 Gy
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Intervention_Physical
10 Gy
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Intervention_Physical
36 Gy
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Intervention_Physical
10 or 36 Gy
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Intervention_Physical
10 Gy
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Intervention_Physical
36 Gy
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Outcome_Physical
severe visual loss
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Outcome_Physical
Fluorescein angiographic growth of classic and occult CNV
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Outcome_Physical
temporary growth retardation
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Outcome_Physical
severe visual loss
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Participant_Condition
age-related macular degeneration ( AMD ) .
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Participant_Condition
patients comprised some randomized to 0 vs 10 vs 36 Gy of radiation and ( after a change of the study protocol became necessary ) others who participated in a prospective , controlled non-randomized pilot study .