Epimacular brachytherapy for wet (neovascular) AMD
There
are many new treatment for age-related macular degeneration (AMD) under
evaluation. I am UK Chief Investigator for a surgical study
looking at focal radiation
treatment, applied inside the eye to the new vessels that cause
wet AMD. It is thought that this may provide a more permanent
treatment than injections such as Lucentis and Avastin, which need
to be
repeated at regular intervals. It may also provide a better visual
outcome, but until the study is completed this cannot be confirmed.
This multicentre study is called CABERNET
and will be
undertaken in a limited number of UK NHS hospitals
and other international sites. The treatment is called
epimacular brachytherapy. The device that delivers the radiation
was called EpiRad but the latest version has been labelled
Vidion. These devices have been developed by
the sponsors of the tial (NeoVista), a
private biotechnology company based in the USA. Following on from CABERNET I have set up a study (MERITAGE)
using the device in patients who have commenced treatment with
anti-VEGF drugs (Avastin/Lucentis), and who require these drugs on a
regular basis. The aim is to reduce patients' need for such
regular Lucenits eye injections. I subsequently set up and lead
the MERLOT
trial of
epimacular brachytherapy. The MERLOT trial is similar to MERITAGE, but
it is a larger trial that will be run throughout the UK. The
CABERNET and MERITAGE studies are now closed to recruitment, but
patients interested in joining the MERLOT study should see below
or click here.
Implantable miniature telescopes
A study is underway at King's College Hospital
using implantable miniature telescopes. These magnify the
image inside the eye and may help some patients with advanced AMD -
both wet and dry types.
How to join a study
All NHS
screening visits require a referral letter from a doctor. If you are currently
being treated by an Ophthalmologist then please ask him or her to write a
referral letter. If you are not being treated by an Ophthalmologist then please
ask your GP to refer you. Referrals
should be addressed to Mr Tim Jackson,
at King's College Hospital. Contact details are available here.
Because of the
media attention surrounding epimacular brachytherapy you may experience a delay in
receiving an appointment. If you have
already commenced treatment with Avastin or Lucentis injections, and you are being
monitored by an Ophthalmologist, then this should not pose a risk. However, if your Ophthalmologist advises you
to commence Lucentis or Avastin injections, and you would like to consider
epimacular brachytherapy instead, then please ask for an urgent referral before commencing the
injections. In this setting it is important to avoid delay - if you do not
receive an appointment within two weeks of your doctor making the referral please contact the study coordinator on 020 3299
1297. If you develop new or worsening symptoms such
as blurred or distorted vision then please visit a doctor urgently.
If you wish to be seen privately for a consultation a referral letter is helpful, but not essential. Click here for contact details.
If you would like more information on the MERLOT study you can visit www.merlotstudy.com.
Further information on AMD
Patient information on AMD is available here. Information for GPs and optometrists is available via the homepage (link below).