Robot radiotherapy combined with injections for the treatment of AMD

UK researchers have trialled the use of a one-off dose of radiation in combination with anti-VEGF injections for the treatment of wet AMD

Surgeons wearing blue gowns and face masks operate on a patient in an operating theatre
Pixabay/Sasin Tipchai

A new study has found that wet age-related macular degeneration (AMD) patients who received a single dose of radiation needed fewer anti-VEGF injections to manage their disease than those who received injections alone.

The research, which was published in The Lancet, involved 411 participants with wet AMD from 30 UK hospitals.

A total of 274 participants were randomly allocated to receive a single dose of radiation from a robotically controlled device, followed by consultations every month over a two-year period – with anti-VEGF injections administered when necessary.

The rest of the 137 patients received the same course of treatment, except that the initial intervention with the robotically controlled device was a sham treatment and did not deliver radiation.

The researchers found that there was a 22% reduction in the number of injections required among the group who received radiation, when compared to the sham group.

They found that adverse events were similar between the two groups, and the added cost of radiation treatment was “more than offset” by the reduction in the need for anti-VEGF injections.

The average saving per participant who received radiation treatment was £565 over the two-year period.

Professor Timothy Jackson, of King’s College London, highlighted that previous attempts to target radiotherapy to the macula had lacked the precision to focus on an area that may be less than 1mm across.

“With this purpose-built robotic system, we can be incredibly precise, using overlapping beams of radiation to treat a very small lesion in the back of the eye,” he shared.

He observed that while patients generally accept they need to have regular injections to preserve their vision, going to the hospital for frequent injections is not something that they enjoy.

“By better stabilising the disease and reducing its activity, the new treatment could reduce the number of injections people need by about a quarter. Hopefully, this discovery will reduce the burden of treatment that patients have to endure,” Jackson said.