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Controversies
November 1998

Radiotherapy and the Treatment of Age-related Macular Degeneration ExternalBeam Radiation Therapy Is Effective in the Treatment of Age-related Macular Degeneration

Arch Ophthalmol. 1998;116(11):1507-1509. doi:10.1001/archopht.116.11.1507

NEOVASCULAR age-related macular degeneration (ARMD) is the leading cause of irreversible blindness in the western world. The only proven treatment involves laser photocoagulation of the abnormal and leaking subretinal vessels associated with neovascular ARMD. This is because several phase 3 efficacy trials have proved that laser photocoagulation of subretinal neovascular membranes in extrafoveal and subfoveal locations was associated with better visual acuity measurements compared with no treatment.1,2 Unfortunately, laser photocoagulation of subfoveal neovascularization induces an immediate central scotoma that is poorly tolerated by most patients, and only 10% to 15% of eyes with neovascular ARMD meet the criteria for laser treatment. Then, despite initial laser photocoagulation of the choroidal neovascularization (CNV), recurrent CNV (which usually affects the fovea and vision) develops in most patients. Since the majority of patients with neovascular ARMD become legally blind despite laser treatment, it is clear that we must investigate new therapies for neovascular ARMD.

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