Article
Epimacular Brachytherapy: an alternative treatment for wet AMD if anti-VEGF-injections fail
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Published: | May 30, 2012 |
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Background: Wet Age related macular degeneration (AMD) is despite of the existence of Avastin and Lucentis still a pressing problem. There is a numerous subgroup of patients that does not respond to the anti-VEGF-treatment. And the patients that respond need prolonged if not lifelong treatment.
Methods: In Epimacular Brachytherapy a vitrectomy is performed and a β-rays eradiating source is placed into the vitreous cavity. Radiation of the subretinal neovascular membrane is performed followed by two injections of Avastin or Lucentis. This is supposed to deactivate the subretinal membrane. Epimacular Brachytherapy is performed at the “Augenklinik am Neumarkt” since May 2011.
Results: The effectiveness of Epimacular Brachytherapy is demonstrated by case reports. Due to the latency of the radiation effect it is to early yet for a statistical analysis. In our own patient population therapy effectiveness varies. Apart from many very positive results there are some patients with a limited or no effect at all.
Conclusions: Epimacular Brachytherapy is an effective treatment for wet AMD. Which subgroup of patients does benefit most is yet unknown. The months to come will have to answer this question. But in general one can say that for patients that do not respond to anti-VEGF injections Epimacular Brachytherapy is a valuable treatment alternative.