E. Mark Shusterman

Plastic Surgery Hospital

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Darius M. Moshfeghi

Stanford University

Michael Gertner

Kona Medical (United States)

Raúl Vélez-Montoya

Asociacion Para Evitar la Ceguera en México Hospital Dr. Luis Sánchez Bulnes

Hugo Quiroz–Mercado

Asociacion Para Evitar la Ceguera en México Hospital Dr. Luis Sánchez Bulnes

Andrew A. Moshfeghi

Southern California Eye Institute

M. J. López-Miranda

Anna Needs Neuroblastoma Answers

Steven R. Sanislo

Stanford University

Peter K. Kaiser

Cleveland Clinic

Virgilio Morales-Cantón

Asociacion Para Evitar la Ceguera en México Hospital Dr. Luis Sánchez Bulnes

Jason S. Slakter

New York University

Cooperative Institutions

Asociacion Para Evitar la Ceguera en México Hospital Dr. Luis Sánchez Bulnes

Stanford University

Smith-Kettlewell Eye Research Institute

Cleveland Eye Clinic

Vita-Salute San Raffaele University

University of Colorado Denver

Information Group on Reproductive Choice

Royal Victoria Hospital

University of Ulster

Queen's University Belfast

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

STEREOTACTIC RADIOTHERAPY FOR WET AGE-RELATED MACULAR DEGENERATION (INTREPID)

Retina (2014)

Timothy L. Jackson E. Mark Shusterman Mark Arnoldussen E Chell Kun Wang

To determine which patients respond best to stereotactic radiotherapy (SRT) for neovascular age-related macular degeneration.Participants (n = 230) receiving intravitreal anti-vascular endothelial growth factor injections for neovascular age-related macular degeneration enrolled in a randomized, double-masked sham-controlled trial comparing 16 Gray, 24 Gray, or Sham SRT. In a post hoc analysis, participants were grouped according to their baseline characteristics, to determine if these influenced SRT efficacy.At 52 weeks, SRT was most effective for lesions ≤4 mm in greatest linear dimension and with a macular volume greater than the median value of 7.4 mm. For 26% of the participants with both these characteristics, SRT resulted in 55% fewer ranibizumab injections (2.08 vs. 4.60; P = 0.0002), a mean visual acuity change that was 5.33 letters superior to sham (+2.18 vs. -3.15 letters; P = 0.0284), and a 71.1-μm greater reduction in mean central subfield thickness (-122.6 vs. -51.5 μm; P = 0.027). Other features associated with a positive response to SRT included pigment epithelial detachment and the absence of fibrosis.Stereotactic radiotherapy is most effective for neovascular age-related macular degeneration lesions that are actively leaking at the time of treatment, and no larger than the 4-mm treatment zone.

Post-hoc analysis

10.1097/iae.0000000000000283

Cite

Citations (18)

16-Gy Low-Voltage X-ray Irradiation Followed by As-Needed Ranibizumab Therapy for AMD: 6-Month Outcomes of a “Radiation-First” Strategy

Ophthalmic surgery, lasers & imaging retina (2011)

Andrew A. Moshfeghi Virgilio Morales Cantón Hugo Quiroz–Mercado Raúl Vélez-Montoya M. J. López-Miranda

To describe the effect of a "radiation-first" combination treatment strategy for neovascular age-related macular degeneration (AMD) with ranibizumab rescue therapy.Non-invasive, externally delivered low-voltage x-ray irradiation at a dose of 16 Gy was given in a single session through three locations in the inferior pars plana in a consecutive series of patients with neovascular AMD. Ranibizumab was administered according to prospectively determined criteria.Thirteen patients completed a 6-month follow-up. All patients lost 15 or fewer ETDRS letters, 7 gained 0 or more ETDRS letters, and 0 gained more than 15 ETDRS letters. Patients received a total of 15 ranibizumab injections following x-ray irradiation at baseline. Two patients received no ranibizumab injections, seven patients received 1 injection, and four patients received 2 injections.Low-voltage x-ray treatment followed by ranibizumab rescue demonstrates an independent visual acuity stabilizing effect for patients with wet AMD.

10.3928/15428877-20110804-03

Cite

Citations (16)

Pre-clinical Evaluation of Oraya’s IRay System for Delivery of Microcollimated Pars Plana External Beam Radiation to the Eye

Rajinder Singh E. Mark Shusterman Darius M. Moshfeghi Tom A. Gardiner Michael Gertner

External beam radiation

Cite

Citations (0)

RETINAL VASCULAR ABNORMALITIES IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Retina (2013)

Timothy L. Jackson Ronald P. Danis Mauro Goldbaum Jason S. Slakter E. Mark Shusterman

To determine the prevalence of retinal vascular abnormalities (RVA) in neovascular age-related macular degeneration (AMD).A post hoc subanalysis of images acquired during a Phase III randomized controlled trial was undertaken, selecting images from participants with untreated, neovascular AMD in at least one eye. Protocol mandated fundus photographs and fluorescein angiograms were acquired at baseline and Year 2, from 107 sham-treated study eyes with neovascular AMD and 107 untreated fellow eyes. Images were reanalyzed by an independent reading center for the presence of RVA, defined as at least one of the following: microaneurysms, vessel staining or leakage, dilated or tortuous vessels, intraretinal hemorrhage, vessel sheathing or narrowing, capillary nonperfusion, or capillary infarcts.The baseline prevalence of RVA in the sham-treated study eyes was 14.4% (15 of 104 gradable images) versus 8.3% (5 of 60) in the fellow eyes with dry AMD. The baseline prevalence of individual RVAs in study eyes was: microaneurysms (6.7%), vessel staining or leakage (6.7%), dilated or tortuous vessels (4.8%), intraretinal hemorrhage (4.8%), vessel sheathing or narrowing (2.9%), capillary nonperfusion (0%), and capillary infarcts (0%). Results were similar at 24 months.Compared with several studies that relied solely on fundus photographs, this study included fluorescein angiography and found a higher prevalence of RVAs occurring in eyes with neovascular AMD.

10.1097/iae.0b013e3182a487be

Cite

Citations (20)

16 Gy low-voltage x-ray irradiation followed by as needed ranibizumab therapy for age-related macular degeneration: 12 month outcomes of a ‘radiation-first’ strategy

British Journal of Ophthalmology (2012)

Andrew A. Moshfeghi Virgilio Morales-Cantón Hugo Quiroz–Mercado Raúl Vélez-Montoya A. Zavala-Ayala

Background and objective

To describe ‘radiation-first’ combination treatment with a non-invasive, low-voltage x-ray irradiation system followed by as needed ranibizumab for neovascular age-related macular degeneration (AMD).

Study design and methods

Phase I study of non-invasive, low-voltage 16 Gy x-ray irradiation delivered in three beams via the inferior pars plana in patients with active neovascular AMD. Ranibizumab was administered as needed per protocol. Patients were followed monthly for safety and efficacy over 12 months.

Results

13 patients were enrolled and completed 12 months follow-up. Safety was good with no serious ocular/non-ocular adverse events or radiation-related ocular complications. 11 patients lost <15 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, seven gained ≥0 ETDRS letters and 0 gained ≥15 ETDRS letters. Patients received a total of 31 subsequent ranibizumab injections (of possible 156) over the 12 months following x-ray irradiation. Mean time to first injection was 3.9 months. One patient received no ranibizumab injections, three patients received one injection, four patients received two injections, and five patients received three or more injections.

Conclusions

After 12 months, non-invasive, low-voltage x-ray irradiation with as needed ranibizumab rescue therapy demonstrated good safety with a visual acuity stabilising effect and reduction in retinal thickness in patients with neovascular AMD.

10.1136/bjophthalmol-2011-301222

Cite

Citations (14)

Assessment of Motion Management in a Stereotactic Radiosurgical Device for the Treatment of Macular Degeneration

Investigative Ophthalmology & Visual Science (2011)

E Chell Mark Arnoldussen E. Mark Shusterman Darius M. Moshfeghi

The purpose of this study is to evaluate the effectiveness of an automated gating algorithm that minimizes the impact of motion during a radiotherapeutic treatment of age-related macular degeneration (AMD). The IRayTM is a non-invasive device that delivers three X-ray beams to the fovea of an unsedated patient. The gating algorithm was developed to ensure accurate targeting despite potentially substantial patient eye movement. It was originally employed in a Phase I safety/feasibility trial and now recent data from a clinical factors study have been added to confirm the design is appropriate for broader use. Results

Degeneration (medical)

Source

Cite

Citations (0)

Evaluation of a Novel External Neuromodulation Device (iCLEAR™) for the Acute Relief of Rhinitis and Rhinosinusitis Symptoms

Archives of Clinical and Medical Case Reports (2023)

E. Mark Shusterman Michael Gertner Anita Carmen Choy Jacob D. Johnson Neil J. Friedman

Purpose: To evaluate the efficacy and safety of a novel portable sonic external neuro-stimulation device (iCLEAR) in alleviating symptoms of chronic rhinitis and rhinosinusitis.

Neuromodulation

Chronic Rhinosinusitis

10.26502/acmcr.96550582

Cite

Citations (1)

16 and 24 Gy Low-voltage X-ray Irradiation With Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration: 12-Month Outcomes

American Journal of Ophthalmology (2013)

Virgilio Morales-Cantón Hugo Quiroz–Mercado Raúl Vélez-Montoya A. Zavala-Ayala Andrew A. Moshfeghi

Verteporfin

10.1016/j.ajo.2013.01.015

Cite

Citations (6)

24-Gy Low-Voltage X-Ray Irradiation With Ranibizumab Therapy for Neovascular AMD: 6-Month Safety and Functional Outcomes

Ophthalmic surgery, lasers & imaging retina (2012)

Virgilio Morales Cantón Hugo Quiroz–Mercado Raúl Vélez-Montoya M. J. López-Miranda Andrew A. Moshfeghi

BACKGROUND AND OBJECTIVE: To describe the 6-month safety and preliminary efficacy outcomes of the use of 24-Gy radiation with intravitreal ranibizumab for patients with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: A single treatment of a non-invasive, externally delivered low-voltage x-ray irradiation at a dose of 24 Gy was administered in one session through three locations in the inferior pars plana in a consecutive series of patients with neo-vascular AMD (treatment naïve and previously treated). Optical coherence tomography (OCT) and Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity examinations were performed at 1 week, 1 month, and monthly thereafter with quarterly fluorescein angiography. RESULTS: Nineteen patients completed 6 months of follow-up. There was no evidence of radiation retinopathy, optic neuropathy, or cataract. The mean baseline ETDRS score was 38.3 ± 19.5 letters. At 6 months, the corresponding ETDRS score was 44.7 ± 16.8 letters. At 6 months, the mean change in visual acuity was 6.4 ± 9.8 ETDRS letters. Patients received an average of 0.4 additional ranibizumab injections following the initial two mandated injections. CONCLUSION: A single treatment of external 24-Gy low-voltage x-ray therapy in conjunction with ranibizumab demonstrated an overall improvement in visual acuity in patients with neovascular AMD at 6 months, with no radiation-related adverse effects.

10.3928/15428877-20111129-01

Cite

Citations (34)

16-Gy Low-Voltage X-ray Irradiation With Ranibizumab Therapy for AMD: 6-Month Safety and Functional Outcomes

Ophthalmic surgery, lasers & imaging retina (2011)

Virgilio Morales Cantón Hugo Quiroz–Mercado Raúl Vélez-Montoya M. J. López-Miranda Andrew A. Moshfeghi

BACKGROUND AND OBJECTIVE: To describe the 6-month safety and preliminary efficacy outcomes of the use of 16-Gy radiation with intravitreal ranibizumab for patients with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: A single treatment of a non-invasive, externally delivered low-voltage 16-Gy x-ray irradiation was administered in one session through three locations in the inferior pars plana. Optical coherence tomography (OCT) and Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA) examinations were performed at 1 week, 1 month, and monthly thereafter, with quarterly fluorescein angiography (FA). After the two initial ranibizumab injections, subsequent injections were administered according to the following criteria: VA decline of 10 ETDRS letters compared with baseline, increase of 100-μm central foveal thickness on OCT compared with baseline, the development of new submacular hemorrhage, and the development of a new area of classic choroidal neovascularization on FA. RESULTS: Twenty-six patients completed a 6-month follow-up. There was no evidence of radiation retinopathy, optic neuropathy, or cataract. The mean baseline ETDRS score was 46.6 letters (range: 5 to 80; standard deviation [SD]: 21.5). At 6 months, the corresponding ETDRS score was 55.6 letters (range: 25 to 80; SD: 18.9) and the mean change in VA was 9.5 ETDRS letters (SD: 10.3). On responder analysis, 96% lost 15 or fewer ETDRS letters, 81% gained 0 or more ETDRS letters, and 50% gained 15 or more ETDRS letters. Patients received a total of 13 ranibizumab injections following two initial injections. At 6 months, patients received an average of 0.5 additional injections following the initial two mandated injections. CONCLUSION: A single treatment of externally applied, non-invasive 16-Gy low-voltage x-ray therapy in conjunction with ranibizumab demonstrated an overall improvement of VA in patients with neovascular AMD at 6 months with no radiation-related adverse effects.

10.3928/15428877-20110804-01

Cite

Citations (18)