Episcleral brachytherapy for treatment resistant nAMD warrants deeper look

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The safety and feasibility of episcleral brachytherapy (ESB) for the treatment of anti-vascular endothelial growth factor (anti-VEGF) resistant neovascular age-related macular degeneration (nAMD) was studied in this a 6-subject cohort.

Six eyes of 6 patients with anti-VEGF resistant nAMD were treated with ESB. Most patients (67%) had polypoidal choroidal vasculopathy.

Prior to the study enrollment, there were a mean of 33.9 lifetime anti-VEGF injections and a mean of 10 injections in the year prior.

In the first following ESB, the mean number of injections was 8.5; in the second year, it was 8 injections.

During the 2 years, post-ESB patients were followed, there was no evidence of radiation-induced toxicity. The mean baseline VA was 55.3 letters and increased by 3.2 letters and 1.7 letters at year 1 and year 2, respectively.

Mean change in vascular complex at 2 years was -18% on indocyanine green angiography, – 43% on optical coherence tomography angiography, and – 5% on fluorescein angiography.

At 2 years, there was also a mean decrease of 21% in CRT on OCT.

The authors concluded that data from this analysis supported additional investigations of ESB for nAMD.

Chhablani J, Jager R, Ong J; Doheny Retina Study Group. Two-year outcomes of episcleral brachytherapy adjunct to anti-VEGF therapy for treatment-resistant nAMD. Graefes Arch Clin Exp Ophthalmol. 2022 Jun 17. doi: 10.1007/s00417-022-05736-0. Epub ahead of print. PMID: 35713709.