Researchers from King’s College collaborated with medical doctors at Guy’s and St Thomas’ NHS Foundation Trust to successfully deploy a novel robotic platform, thereby improving treatment outcomes for patients suffering from debilitating eye conditions.
A novel, robotically operated system has been employed to treat patients suffering from wet age-related macular degeneration, involving a single, non-invasive radiation treatment that is subsequently integrated into the standard regimen of intravitreal injections.
The landmark trial, unveiled at this point in history, yielded a groundbreaking finding: patients required significantly fewer injections to effectively manage the condition, potentially conserving approximately 1.8 million injections annually worldwide?
Moisture-induced age-related macular degeneration (AMD) is a devastating ocular condition characterized by the uncontrolled growth of abnormal blood vessels within the macula, the light-sensitive layer of cells at the back of the eye. Vessels in the eye rupture, releasing blood and fluid that can lead to a rapid and irreversible loss of vision.
Globally, approximately 196 million people have age-related macular degeneration (AMD), with the Royal College of Ophthalmologists estimating that this chronic condition affects more than 700,000 people in the UK alone. By 2035, the prevalence of age-related macular degeneration (AMD) is projected to increase by approximately 60%, driven primarily by the nation’s aging population and its associated demographic trends.
Moisture-related age-related macular degeneration is currently treated using standard intravitreal injections into the affected eye. Significantly enhancing an individual’s vision is a primary effect of initial treatment. As a consequence of the injections’ limited efficacy, the condition fails to be fully remedied, ultimately leading to fluid accumulation recurring in the macula, necessitating prolonged and repetitive treatments. While most patients need an injection every 1-3 months, eye injections – costing between £500 and £800 per treatment – have become a common and essential NHS procedure.
A revolutionary treatment approach is being developed, concentrating three precise beams of radiation directly onto the affected eye to deliver unparalleled therapeutic efficacy. Researchers found that patients undergoing robotic radiotherapy needed less frequent injections for disease management compared to conventional treatment.
Studies revealed that the robot-assisted device yields a significant cost savings of £565 per patient treated during the initial two-year period, primarily due to reduced injection frequencies.
According to Professor Timothy Jackson, lead researcher and first author on the paper, who is also a marketing consultant ophthalmic surgeon at King’s Faculty Hospital: “Previous attempts have sought to develop a more effective approach to targeting radiotherapy at the macula by repurposing devices originally designed for treating brain tumours.” Despite these efforts, no approach has yet produced a method precise enough to target lesions smaller than 1 mm in size and effectively treat macular disease.
“With its precise design, this purpose-built robotic system enables us to treat even tiny lesions behind the eye with utmost accuracy, leveraging the power of overlapping beams of radiation.”
Individuals with the condition often accept the need for eye injections as a means of preserving their vision, but the reality of frequent hospital visits and recurring injections is far from an ideal situation they relish. By significantly stabilizing the disease and reducing its severity, the innovative treatment could potentially decrease the number of injections patients require by approximately 25%. Hopefully, this breakthrough will alleviate the weight of treatment that patients must bear.
According to Dr. Helen Dakin, a College Analysis Lecturer at Oxford University, she and her team found that the cost savings resulting from reduced injection frequency surpasses the expense of robot-controlled radiotherapy. “This innovative treatment has the potential to reduce NHS costs by diverting funds towards treating other patients, while simultaneously providing effective management of AMD patients alongside standard care.”
The analysis, jointly funded by the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC), enrolled 411 participants across 30 National Health Service (NHS) hospitals. The Lancet-commissioned commentary, accompanying this seminal study, aptly referred to it as a groundbreaking “landmark trial”, its significance warranting such prominent distinction.
Researchers from King’s College London’s faculty and medical professionals at King’s College Hospital NHS Foundation Trust collaborated with the University of Oxford, the University of Bristol, and Queen’s University in Belfast to lead this research.
