THOSE WHO manage patients with neovascular age-related macular degeneration(AMD) entered the 21st century armed with an effective new treatment: photodynamic therapy with verteporfin. For a select group of patients, specifically those with predominantly classic choroidal neovascularization, loss of vision now can be slowed or halted for at least 2 years. As the evidence in support of photodynamic therapy has accumulated, so has evidence supporting the lack of benefit gained from external beam radiotherapy. First put forth by Chakravarthy et al in 1993,1 external beam radiotherapy showed no advantage over sham treatment in a randomized clinical trial of 205 patients conducted by the German Radiation Therapy for Age-related Macular Degeneration (RAD) Study Group.2 In this issue of the ARCHIVES, Marcus and colleagues3 studied 83 eyes in a double-masked randomized trial and found that vision and anatomic outcomes were similar in the radiation-treated and sham-treated groups 1 year after study entry. It then seems reasonable to ask, "Is it time to abandon radiotherapy for neovascular age-related macular degeneration?"
Fine SL, Maguire MG. It Is Not Time to Abandon Radiotherapy for Neovascular Age-Related Macular Degeneration. Arch Ophthalmol. 2001;119(2):275–276. doi:10-1001/pubs.Ophthalmol.-ISSN-0003-9950-119-2-eed00028