Objective: To determine the efficacy of strontium plaque (Sr90) brachytherapy for age-related macular degeneration (AMD) with subfoveal choroidal neovascular ization (CNV). Design: Randomized clinical trial. Participa...Objective: To determine the efficacy of strontium plaque (Sr90) brachytherapy for age-related macular degeneration (AMD) with subfoveal choroidal neovascular ization (CNV). Design: Randomized clinical trial. Participants: Eighty-eight eyes of 86 patients with subfoveal CNV secondary to AMD were randomized either to plaque radiotherapy or to observation. Intervention: Radiotherapy was given as episcleral brachytherapy using Sr 90 plaques. Two different plaque types were used. Plaque I had a diameter of 8mm and delivered a dose of 15 Gy at a depth o f 1.75 mm in 54 minutes. With plaque II, the corresponding values were 4 mm, 12. 6 Gy, and 11 minutes. The control group was observed without any treatment. Main Outcome Measures: The primary outcome measure was visual acuity at 6, 12, 24, a nd 36 months. Other outcome variables were contrast sensitivity, fluorescein ang iographic, and clinically evaluated changes in the macula. Results: Eighty-two patients (84 eyes [95%]) completed the 1-year follow-up, and 80 (93%) and 74 (86%) patients completed the 2-and 3-year follow-ups, respectively. At 6 mo nths, visual loss of < 3 lines occurred in 20%of treated patients and 42%of co ntrol patients (P=0.031). At 12 months, a visual loss of < 3 lines occurred in 4 5%(treated) and 56%(controls) (P=0.325); at 24 months, in 73%and 71%(P=0.914 ); and at 36 months, in 80%and 84%of patients (P=0.591), respectively. Patient s irradiated with plaque I had better results: a visual loss of < 3 lines occurr ed in 6%at 6 months (P=0.008, relative to controls), in 18%at 12 months (P=0.0 07), in 59%at 24 months (P=0.348), and in 71%at 36 months (P=0.212). In patien ts treated with plaque II, the corresponding values were 29%(P=0.032), 65%(P=0 .459), 83%(P=0.317), and 80%(P=0.687) at 6, 12, 24, and 36 months, respectivel y. Conclusions: The short-term clinical course of exudativeAMD is affected by S r90 brachytherapy, but by 12 months, there was no treatment benefit.展开更多
文摘Objective: To determine the efficacy of strontium plaque (Sr90) brachytherapy for age-related macular degeneration (AMD) with subfoveal choroidal neovascular ization (CNV). Design: Randomized clinical trial. Participants: Eighty-eight eyes of 86 patients with subfoveal CNV secondary to AMD were randomized either to plaque radiotherapy or to observation. Intervention: Radiotherapy was given as episcleral brachytherapy using Sr 90 plaques. Two different plaque types were used. Plaque I had a diameter of 8mm and delivered a dose of 15 Gy at a depth o f 1.75 mm in 54 minutes. With plaque II, the corresponding values were 4 mm, 12. 6 Gy, and 11 minutes. The control group was observed without any treatment. Main Outcome Measures: The primary outcome measure was visual acuity at 6, 12, 24, a nd 36 months. Other outcome variables were contrast sensitivity, fluorescein ang iographic, and clinically evaluated changes in the macula. Results: Eighty-two patients (84 eyes [95%]) completed the 1-year follow-up, and 80 (93%) and 74 (86%) patients completed the 2-and 3-year follow-ups, respectively. At 6 mo nths, visual loss of < 3 lines occurred in 20%of treated patients and 42%of co ntrol patients (P=0.031). At 12 months, a visual loss of < 3 lines occurred in 4 5%(treated) and 56%(controls) (P=0.325); at 24 months, in 73%and 71%(P=0.914 ); and at 36 months, in 80%and 84%of patients (P=0.591), respectively. Patient s irradiated with plaque I had better results: a visual loss of < 3 lines occurr ed in 6%at 6 months (P=0.008, relative to controls), in 18%at 12 months (P=0.0 07), in 59%at 24 months (P=0.348), and in 71%at 36 months (P=0.212). In patien ts treated with plaque II, the corresponding values were 29%(P=0.032), 65%(P=0 .459), 83%(P=0.317), and 80%(P=0.687) at 6, 12, 24, and 36 months, respectivel y. Conclusions: The short-term clinical course of exudativeAMD is affected by S r90 brachytherapy, but by 12 months, there was no treatment benefit.
