Robot radiotherapy may improve therapies for eye diseases.

Researchers at King's College London and doctors at King's College Hospital NHS Foundation Trust have successfully used a new robotic system to improve treatment of a debilitating eye disease.

This custom robot is used to treat wet neovascular age-related macular degeneration (AMD). The landmark study, published in The Lancet, found that patients needed fewer injections to effectively control the disease, potentially saving around 1.8 million injections a year worldwide.

Wet AMD is a debilitating eye disease in which abnormal new blood vessels grow in the macula, a layer of photoreceptor cells at the back of the eye. The blood vessels then begin to leak blood and fluid, often causing rapid, permanent and severe blindness.

Around 196 million people worldwide have AMD, and the Royal College of Ophthalmologists estimates that the disease affects more than 700,000 people in the UK. By 2035, the number of people with AMD is expected to increase by 60% due to the aging of the country's population.

Wet AMD is currently treated with regular injections into the eye. Initially, treatment substantially improves a patient\'s vision. But because the injections do not cure the disease, eventually the fluid will start to build up again in the macula, and patients will need repeated injections over a long period of time. Most people need an injection approximately every 1-3 months, and eye injections cost between £500 and £800 per injection, making them one of the most common procedures on the NHS. The new treatment is more targeted than existing methods, firing three highly focused beams of radiation into the diseased eye. Scientists found that patients who received robotic radiation therapy needed fewer injections to control their disease compared with standard treatments.

The study found that the robot-guided device saves the NHS £565 for every first patient treated over two years because it results in fewer injections Study leader and first author Professor Timothy Jackson, consultant ophthalmic surgeon at King's College London and King's College Hospital, said: "Research has previously tried to find a better way to target radiotherapy to the macula, for example by redesigning 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 believe they need eye injections to help protect their vision, but frequent hospital visits and repeated eye injections are frowned upon. By better stabilizing the disease and reducing its activity, the new treatment could cut the number of injections people need by about a quarter. Hopefully, this discovery will reduce the burden of treatment that patients have to endure. "Dr. Helen Dakin, University Research Lecturer at the University of Oxford, said, "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."

This study was led by researchers from King's College London and doctors at King's College Hospital NHS Foundation Trust, in collaboration with the University of Oxford, the University of Bristol and Queen's University in Belfast.