Macular Degeneration

Epimacular brachytherapy - a new treatment option for neovascular ARMD

News Epimacular Brachytherapy for Age-Related Macular Degeneration (AMD)


June 15, 2011

Epimacular brachytherapy - a new treatment option for neovascular ARMD

Lars Wagenfeld - Universitäts-Augenklinik Eppendorf, Hamburg
H. Bouterfa - Octreopharm Vertriebs GmbH, Waldburg
J. Nau - Neovista Inc., Newark, CA, USA
G. Richard - Universitäts-Augenklinik Eppendorf, Hamburg

German Retina Society. 24th Annual Conference of the German Retina Society. Aachen, 17.-18.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11rg36

DOI: 10.3205/11rg36, URN: urn:nbn:de:0183-11rg364

Background: The observation that long term follow-up of neovascular ARMD treated with anti-VEGF shows a decrease of visual acuity and the fact that certain subtypes of wet ARMD cannot be sufficiently treated with anti-VEGF demonstrates the need of alternative treatment options. Ionizing radiation seems to be a logical treatment. Cells in segmentation can be affected by radiation, scar reaction is reduced and local inflammation can be minimized.

Methods: In a randomized multicenter study (MERITAGE) a total of 53 patients that received - after initial treatment with a loading dose of 3 anti-VEGF injections - a minimum of 6 additional injections in the 12 months preceding enrollment or 3 injections in the last 6 months were enrolled. The patients were treated with vitrectomy, epimacular brachytherapy and an additional ranibizumab injection. Besides the data of this study, first impressions of the use of epimacular in clinical routine in Hamburg will be presented.

Results: A total of 53 patients with wet ARMD were included. 49 patients could be included in the 18 months follow up. In this collective the average amount of injections prior to brachytherapy was 12.2. 18 months after radiation the average was 5.6 injections. 18% of patients had received no additional anti-VEGF injection. 39% received less than 2 injections during this 18 months period. Visual acuity could be stabilized or improved in 84% of patients with an average improvement of 6.6 letters.

Conclusion: The current monotherapy model with anti-VEGF is a great burden for all involved persons. With epimacular brachytherapy we have a new and promising treatment option for refractory wet ARMD.

This is the translated version of the article.
The orginal version can be found at:
Epimakuläre Brachytherapie - eine neue Therapieoption bei neovaskulärer AMD

Published: June 15, 2011

© 2011 Wagenfeld et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share - to copy, distribute and transmit the work, provided the original author and source are credited.