Low-Energy Stereotactic Radiotherapy for Treatment of Exudative Age-Related Macular Degeneration in a Treat-and-Extend Regimen.

BACKGROUND AND OBJECTIVE: To evaluate the effectiveness and safety of low-energy stereotactic radiotherapy (SRT) combined with anti-vascular endothelial growth factor (VEGF) treatment following a treat-and-extend regimen (TER) in wet age-related macular degeneration (AMD). PATIENTS AND METHODS: Before/after SRT, the authors compared retrospective consecutive case series of 50 patients requiring frequent anti-VEGF treatment (every 4 or 6 weeks) in wet AMD, treated with a single session of SRT and TER (same manner pre/post-SRT). Outcomes were visual acuity (VA), recurrence-free interval, and central retinal thickness (CRT). RESULTS: After SRT, CRT was reduced from baseline (407.3 mu m +/- 153.2 mu m) to 12 months (320.2 mu m +/- 112.1 mu m; P <.001), with statistical significance from month 2 onward. VA was stable for 12 months (64.0 letters +/- 15.1 letters vs. 63.6 letters +/- 16.2 letters). The mean recurrence-free interval increased from 4.24 weeks +/- 0.66 weeks to 7.52 weeks +/- 3.05 weeks at 12 months (P <.001). No severe side effects were observed. CONCLUSION: Low-energy SRT, combined with antiVEGF TER, was associated with reduced injection frequency and preserved VA during 12 months of follow-up.