Radiotherapy delivered by robots could improve treatment for common eye disease

Radiotherapy administered by robots could improve treatment for a debilitating eye condition, a trial has found.

The approach means patients would no longer require regular injections into their eye to preserve their vision.

The savings made from a fall in the number of jabs were also larger than the cost of the robot-controlled radiotherapy, researchers said.

Age-related macular degeneration (AMD) is a common eye disease that affects people in their 50s and 60s.

Wet AMD – when the condition comes on quickly over weeks or months – is caused by tiny blood vessels that grow in the back of the eye and leak fluid, causing scarring.

The disease impacts the middle of the vision, and while it does not cause total blindness, it can make reading, driving and recognising faces difficult.

Treatment includes regular jabs of a medication known as ranibizumab into the eye.

The trial, published in The Lancet, comprised 411 wet AMD patients from across 30 NHS hospitals.

It found those who were treated with radiation using the robot system required 22% fewer injections in the following two years.

Study lead and first author, Professor Timothy Jackson, consultant ophthalmic surgeon at King’s College Hospital, said: “Research has previously tried to find a better way to target radiotherapy to the macula, such as by repurposing devices used to treat brain tumours.

“But so far nothing has been sufficiently precise to target macular disease 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.

“Patients generally accept that they need to have eye injections to help preserve their vision, but frequent hospital attendance and repeated eye injections isn’t something 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.”

According to the The Royal College of Ophthalmologists, AMD is the biggest cause of sight loss in the UK, affecting more than 700,000 people.

It estimates there are almost 40,000 new diagnoses of wet AMD each year.

Researchers said the savings from reducing ranibizumab injections “more than offset” the cost of providing radiation using robots.

The estimated mean saving per patient in the trial was £565 over two years.

Dr Helen Dakin, university research lecturer at the University of Oxford, added: “We found that the savings from giving fewer injections are larger than the cost of robot-controlled radiotherapy.

“This new treatment can therefore save the NHS money that can be used to treat other patients, while controlling patients’ AMD just as well as standard care.”

One of the first patients to have the new treatment is Peter Frewin, 75, from Bromley.

Prior to the trial, an eye injection cleared up a dark spot, allowing him to drive normally.

However, he would have required an average of four injections a year to keep his condition stable.

After the trial, Mr Frewin was able to go two years without a further jab, and had just one injection in 2023.

He said: “I definitely felt a beneficial effect as it went on for a nice long time before a further injection was needed. I felt relieved, and it is great that I can continue to drive.”