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16-Gy Low-Voltage X-ray Irradiation Followed by As-Needed Ranibizumab Therapy for AMD: 6-Month Outcomes of a "Radiation-First" Strategy

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16-Gy Low-Voltage X-ray Irradiation Followed by As-Needed Ranibizumab Therapy for AMD: 6-Month Outcomes of a "Radiation-First" Strategy OPHTHALMIC SURGERY LASERS & IMAGING Moshfeghi, A. A., Canton, V. M., Quiroz-Mercado, H., Velez-Montoya, R., Lopez-Miranda, M. J., Shusterman, E. M., Kaiser, P. K., Sanislo, S. R., Gertner, M., Moshfeghi, D. M. 2011; 42 (6): 460-467

Abstract

To describe the effect of a "radiation-first" combination treatment strategy for neovascular age-related macular degeneration (AMD) with ranibizumab rescue therapy.Non-invasive, externally delivered low-voltage x-ray irradiation at a dose of 16 Gy was given in a single session through three locations in the inferior pars plana in a consecutive series of patients with neovascular AMD. Ranibizumab was administered according to prospectively determined criteria.Thirteen patients completed a 6-month follow-up. All patients lost 15 or fewer ETDRS letters, 7 gained 0 or more ETDRS letters, and 0 gained more than 15 ETDRS letters. Patients received a total of 15 ranibizumab injections following x-ray irradiation at baseline. Two patients received no ranibizumab injections, seven patients received 1 injection, and four patients received 2 injections.Low-voltage x-ray treatment followed by ranibizumab rescue demonstrates an independent visual acuity stabilizing effect for patients with wet AMD.

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