Neffendorf James E, Jackson Timothy L
Department of Ophthalmology, School of Medicine, King's College London, London, United Kingdom.
Clin Ophthalmol. 2015 Sep 28;9:1829-34. doi: 10.2147/OPTH.S75638. eCollection 2015.
Neovascular age-related macular degeneration is a leading cause of blindness in the developed world. Currently, the treatment of choice is intravitreal injections of anti-VEGF medications. These require frequent dosing, up to monthly, and impose a substantial burden on patients and the health economy. Ionizing radiation was proposed as a possible treatment for age-related macular degeneration due to its anti-inflammatory and anti-fibrotic properties. Stereotactic radiotherapy is an outpatient-based radiotherapy platform that provides stereotactic application of low energy X-ray to the retina in three highly collimated beams that cross the inferior sclera to overlap at the macula. A randomized, double-masked, sham-controlled trial of 230 patients (INTREPID) showed that a single dose of stereotactic radiotherapy significantly reduces the number of intravitreal anti-VEGF injections needed over 2 years. A larger randomized controlled trial (STAR) is underway.
新生血管性年龄相关性黄斑变性是发达国家失明的主要原因。目前,首选的治疗方法是玻璃体内注射抗血管内皮生长因子(VEGF)药物。这些药物需要频繁给药,每月一次,给患者和卫生经济带来了沉重负担。由于其抗炎和抗纤维化特性,电离辐射被提议作为年龄相关性黄斑变性的一种可能治疗方法。立体定向放射治疗是一种基于门诊的放射治疗平台,它通过三条高度准直的光束对视网膜进行立体定向低能X射线照射,这些光束穿过巩膜下部在黄斑处重叠。一项针对230名患者的随机、双盲、假对照试验(INTREPID)表明,单次立体定向放射治疗可显著减少两年内所需的玻璃体内抗VEGF注射次数。一项更大规模的随机对照试验(STAR)正在进行中。