Treatment of age-related macular degeneration

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina,
• properly locating the distal end of the catheter behind the macular region by directing a preselected pattern of light toward the retina from the front of the eye, and detecting the pattern of light using detectors located near the distal end of the catheter, in such a way as to indicate a direction of movement for correction of the catheter's position, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina, the switchable x-ray source comprising a miniature x-ray tube emitting a side-looking directional radiation,
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane, and including filtering the radiation emitted from the x-ray source to harden the x-ray beam, using one or more filters coated onto the tube or a sleeve over the tube, thus reducing unwanted dose in the sclera.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane, and including filtering the radiation emitted from the x-ray source to harden the x-ray beam, using one or more filters coated onto the tube or a sleeve over the tube, thus reducing unwanted dose in the sclera.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina,
• properly locating the distal end of the catheter by a protrusion in the surface of the catheter, near its distal end, and the method including viewing the retina from the front of the eye as the catheter is inserted, thus observing a protrusion in the retina caused by the protrusion on the catheter, until the catheter is properly positioned, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina,
• the catheter including a guide having a non-round elongated internal cavity, the x-ray source having a complementary shape fitted to the non-round cavity so as to orient the x-ray tube rotationally within the guide, and the non-round cross sectional shape in the guide comprising generally a keyhole shape or an elliptical shape, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina,
• administering to the patient vascularly a radiosensitizing drug, in an effective amount to sensitize the cells in the choroidal layer such that a lower dose or x-ray radiation can be delivered, and then
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane.

A method for treating AMD in combination with photodynamic therapy administered to the eye, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane,
• and the method including administering a photo-activated substance vascularly to the patient and then photo-activating the substance by directing light through the front of the eye to thereby disrupt CNV vasculature in the choroid layer at the macula, the x-ray radiation serving to disable rapidly dividing cells of the CNV vasculature and to assist in the effects of the photodynamic therapy by preventing a repair response which naturally follows photodynamic treatment.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina, including properly locating the catheter behind the macular region by exciting a fluorescent substance on the catheter with x-ray radiation from the source, and viewing the fluorescent substance using an optical instrument from the front of the eye, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane.

A method for treating AMD, comprising:

• inserting an applicator around the globe of the eye of a living patient, the applicator having at least one guide channel, and sliding a catheter into the guide channel of the applicator to slide the catheter around the globe of the eye, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the macular region of the retina, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroid membrane.

A method for treating AMD, comprising:

• sliding an applicator around the globe of the eye of a living patient, the applicator having a plurality of parallel guide channels, to a position behind the macular region of the retina,
• verifying accurate positioning of the applicator, and
• sliding a catheter containing an x-ray source capable of directional emission through the plural guide channels in succession, to deliver a prescription dose of radiation through the sclera into targeted tissue of the choroid membrane.

A method for inserting and correctly locating an applicator having parallel guides by insertion peripherally around the globe of the eye, for therapeutic treatment of the eye, comprising locating the applicator behind the macular region by activating light sources on the applicator, and viewing the light sources using an optical instrument from the front of the eye, the light sources being visible through the sclera, choroid and retina.

A method for inserting and correctly locating a therapeutic probe or applicator by insertion around the globe of the eye, for therapeutic treatment of the eye, comprising locating the distal end of the probe or applicator behind the macular region by directing a preselected pattern of light toward the retina from the front of the eye, and detecting the pattern of light using detectors located near the distal end of the probe or applicator, in such a way as to indicate a direction of movement for correction of the position of the probe or applicator.

A method for inserting and correctly locating a therapeutic probe or applicator by insertion peripherally around the globe of the eye, for therapeutic treatment of the eye, comprising locating the distal end of the probe or applicator by a protrusion in the surface of the probe or applicator, near its distal end, and the method including viewing the retina from the front of the eye as the probe or applicator is inserted, thus observing a protrusion in the retina caused by the protrusion on the probe or applicator, until the probe or applicator is properly positioned.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the sclera and not directly behind the macular region of the retina, and including properly locating the catheter behind the sclera in proper position aimed at the choroidal layer by activating light sources on the catheter and viewing the light sources using an optical instrument from the front of the eye, the light sources being visible through the sclera, choroid and retina, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroidal layer, in a direction essentially tangential or chordal relative to the globe of the eye, essentially not passing radiation through the retina.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the sclera and not directly behind the macular region of the retina, the x-ray tube being shielded to provide a desired, limited directional radiation in a tangential or chordal direction relative to the globe of the eye, and including filtering the radiation to be emitted from the x-ray source to harden the x-ray beam, using one or more filters coated onto the tube or onto a sleeve surrounding the tube, thus reducing unwanted dose in the sclera, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroidal layer, in a direction essentially tangential or chordal relative to the globe of the eye, essentially not passing radiation through the retina.

A method for treating AMD, comprising:

• sliding a catheter around the globe of the eye of a living patient, the catheter containing a switchable x-ray source capable of directional emission in a distal end of the catheter, to a position behind the sclera and not directly behind the macular region of the retina, and including properly locating the distal end of the catheter by a protrusion in the surface of the catheter, near its distal end, and the method including viewing the retina from the front of the eye as the catheter is inserted, thus observing a protrusion in the retina caused by the protrusion on the catheter, until the catheter is properly positioned, and
• switching on the x-ray source to emit directed radiation through the sclera into the choroidal layer, in a direction essentially tangential or chordal relative to the globe of the eye, essentially not passing radiation through the retina.

A method for treating a tumor in or adjacent to the eye of a patient, comprising:

• inserting an applicator around the globe of the eye, the applicator having at least one guide channel, and sliding a catheter into the guide channel of the applicator to thereby slide the catheter around the globe of the eye, the catheter containing a switchable x-ray source in a distal end of the catheter, to a position adjacent to the tumor, and
• switching on the x-ray source to emit radiation to deliver a prescription dose to the tumor.