This Issue At A Glance

Can ionizing radiation be used as an adjunctive treatment for neovascular age-related macular degeneration (AMD)? In the INTREPID study of low-voltage, external-beam, stereotactic radiotherapy (SRT), Jackson et al (p. 1893) found that SRT can significantly reduce the need for retreatment with intravitreal injections of ranibizumab in AMD patients. In this double-masked, sham-controlled study, 230 patients were randomized to receive pro re nata (PRN) ranibizumab plus either 16 Gy, sham 16 Gy, 24 Gy, or sham 24 Gy; data from the 2 sham arms were pooled for all analyses. At the end of the 52-week study, patients in the 16-Gy and 24-Gy SRT arms had received fewer ranibizumab retreatments than those in the sham arms—2.64 (median, 2), 2.43 (median, 2), and 3.74 (median, 3.5), respectively. Results in terms of visual acuity, total angiographic lesion area, and foveal center point thickness also were encouraging. The number of adverse events (AEs) and serious AEs (SAEs) were similar across all treatment arms; no AEs were attributed to radiation; and no SAEs occurred in study eyes.