Avaliação da eficácia e segurança do uso de radioterapia intraocular com estrôncio 90 e bevacizumabe no tratamento de pacientes portadores de degeneração macular relacionada à idade, forma exsudativa
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Data
2012-03-27
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Universidade Federal de Goiás
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Purpose: To evaluate the efficacy and safety of strontium-90 epimacular brachytherapy combined with intravitreal bevacizumab for treating subfoveal choroidal neovascularization secondary to exudative age-related macular degeneration. Its effects on visual acuity and macular thickness at 36 months of follow up were also studied.
Methods: Sixteen patients with predominantly classic, minimally classic and occult choroidal neovascularization were treated with a single 24 Gy dose of radiation during pars plana vitrectomy, associated to two injections of bevacizumab at baseline and one injection at the one-month visit. The patients underwent a complete ophthalmologic examination, which included fluorescein angiography and optical coherence tomography, at the initial visit, every three months during the first year, and every six months during the second and third years of follow up.
Results: Of the 16 cases, 2 patients (12.5%) lost more than 15 letters at the end of 36 months, and 3 (18.75%) lost fewer than 15 letters. Among the patients with improved visual acuity, 3 (18.75%) gained less than 15 letters and 8 (50%) gained more than 15 letters at the end of treatment. The mean best corrected visual acuity showed a gain of 16.0 letters at 12 months. After 36 months (n = 16), the mean best corrected visual acuity showed a gain of 10.4 letters. Of the 16 eyes included in the study, six required further therapy. The evaluation of macular thickness showed decreased thickness in 10, among the 16 patients (62.5%). Three eyes (18.75%) had similar values at the beginning and the end of 36 months, and 3 eyes (18.75%) showed increased macular thickness. Conclusion: Epimacular brachytherapy combined with bevacizumab may be considered a possible therapeutic option for choroidal neovascularization in age-related macular degeneration. The procedure was thought to be safe and was well tolerated by the patients. The treatment resulted in anatomical and functional improvements, compatible with currently available therapies.
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BIANCHI, Lívia Carla de Souza Nassar. Three-year safety and visual acuity results of epimacular straontium-90*ytrium90 brachytherapy with bevacizumab for the treatment of sobfoveal chorodoidal neovascularization secondary to agerelated macular degerenation. 2012. 113 f. Dissertação (Mestrado em Ciências da Saúde - Medicina) - Universidade Federal de Goiás, Goiânia, 2012.