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Radiation Retinopathy


Presentation

  • Choroidal neovascularization may be associated with radiation retinopathy and, when present, may require indocyanine green angiography for its diagnosis.[ncbi.nlm.nih.gov]
  • Retinal nonperfusion was also present, leading the diagnosis of radiation retinopathy. The right eye developed cataract 32 months later followed by cataract surgery.[okayama.pure.elsevier.com]
Disability
  • Careful monitoring of the patient and judicious photocoagulation can help preserve vision in patients who may otherwise be severely disabled for a variety of reasons.[djo.org.in]
  • Careful monitoring of the patient and judicious photocoagulation can help preserve vision 906 in patients who may otherwise be severely disabled for a variety of reasons. REFERENCES 1. Stallard HB.[medtextfree.wordpress.com]
Hodgkin Lymphoma
  • METHODS AND MATERIALS: A 40-year retrospective review was performed of patients who received external beam radiation therapy for ocular/orbital non-Hodgkin lymphoma (NHL).[ncbi.nlm.nih.gov]
Anemia
  • Marie Curie, in fact, the revered physicist who conducted the world’s first studies of radioactive isotopes to treat cancer, died in 1934 of aplastic anemia, her demise widely attributed to unshielded work with radiation.[djo.org.in]
Nausea
  • One patient had a Grade I adverse reaction of nausea/syncope during an injection. The other two patients had no adverse events. The patients enrolled currently have a follow up of 9 months, 5 months, and 2 months.[iovs.arvojournals.org]
Macula Edema
  • Figure 4: Optical coherence tomogram shows cystoid macula edema (a-b). Six months after intravitreal bevacizumab injection (c-d). Past medical history included radiation therapy for nasopharyngeal carcinoma 8 years ago.[omicsonline.org]
Visual Impairment
  • A 53-year old male presented with visual impairment in right eye after irradiation of right maxillary sinus carcinoma. Funduscopy shows radiation retinopathy: haemorrhages, exudates, macular oedema, and peripheral retinal ischaemia.[ncbi.nlm.nih.gov]
Epistaxis
  • He initially presented with epistaxis of 9 months duration. He was evaluated and CT scan showed sinonasal growth left side with infiltrates in ethmoid, sphenoid sinuses and orbit. Biopsy showed squamous cell carcinoma in left maxilla.[djo.org.in]

Workup

  • Current Stan dard Workup for R adiation Maculopathy Radiation retinopathy is typically detected on ophthalmoscopic examination and confirmed with fluorescein angiography (FA) revealing retinal vascular abnormalities such as retinal hemorrhage and exudation[eyecareupdate.com]
  • In these cases, vascular risk factors need to be aggressively controlled, but very little workup is obtained.[neuro-ophthalmology.stanford.edu]
Gliosis
  • Acellular, nonperfused, and collapsed capillaries are a feature of ischemic retina and are associated with varying degrees of neuronal degeneration and gliosis.[medtextfree.wordpress.com]
Ischemic Changes
  • For RR patients, the measurements were taken once in both eyes after confirming the ischemic changes by wide-field fluorescein angiography.[uwspace.uwaterloo.ca]
  • 2 includes macular ischemic changes, stage 3 includes additional macular edema and retinal neovascularization, and stage 4 encompasses vitreous hemorrhage and at least 5 disc areas of retinal ischemia, whether macular or extramacular.[clinicalgate.com]
  • The system consisted of four stages, with stage 1 indicating extramacular ischemic changes and stage 2 macular ischemic changes.[retinatoday.com]
  • The retinal ganglion cells are highly radioresistant and, although axoplasmic stasis is a feature of acute radiation papillopathy, it is probably secondary to ischemic changes at the optic nerve head.[medtextfree.wordpress.com]

Treatment

  • SUMMARY: Currently, there are no proven treatments for radiation retinopathy or maculopathy. The current treatment methods require frequent administration with variable improvement in visual acuity.[ncbi.nlm.nih.gov]

Prognosis

  • CONCLUSIONS: The presence of macular edema and proliferation indicates more severe retinopathy and worse visual prognosis than for eyes without macular edema and proliferation.[ncbi.nlm.nih.gov]
  • Within the retina, the posterior pole is particularly sensitive to this pathology, 13 with grave implications for visual prognosis.[clinicalgate.com]
  • Prognosis: Patients with Non- proliferative retinopathy retain a visual acuity of 6/15(20/50) for at least 4 yrs. Proliferative retinopathy has a very poor prognosis with 86% patients having visual acuity of 20/200 or worse after 6 years.[djo.org.in]
  • So the prognosis for vision and globe salvage was worse. Laser treatment and intravitreal injection was considered at radiation if ischeamic changes and macular edema devoleped.[omicsonline.org]

Etiology

  • Sections and Some Topics Include: • Basic Principles o Cancer etiology; cancer genetics, principles of laser therapy, and more • Eyelid Tumors o Benign epidermal tumors; melanoma of the eyelid, systemic associations, and more • Conjunctival and Corneal[books.google.com]
  • Etiology Exposure to any radiation source including external beam and plaque brachytherapy.[eyewiki.aao.org]
  • […] patientвs level of knowledge about the disease and the modes nasla disease transmission is evaluated. 2 Nas al Retinochoroidal Atrophy Mobic and nasal polyps retinochoroidal atrophy is a non- progressive, regional chorioretinal atrophy mobicc unknown etiology[luxbar-starway.ru]

Epidemiology

  • EPIDEMIOLOGY AND PATHOGENESIS Radiation Dose The key determinants in the development of radiation retinopathy are the total dose of radiation administered to the retina and the fraction size in the case of teletherapy.[medtextfree.wordpress.com]
Sex distribution
Age distribution

Pathophysiology

  • BACKGROUND: to review the currently available therapeutic modalities for radiation retinopathy (RR), including newer investigational interventions directed towards specific aspects of the pathophysiology of this refractory complication.[ncbi.nlm.nih.gov]
  • Clinical picture can be identical to that of diabetic retinopathy suggesting a common pathophysiologic mechanism of the damage to capillary endothelial cells, and the importance of clinical examination, anamnesis and fluorescein angiography.[ingentaconnect.com]
  • Staging of radiation retinopathy has been proposed. [3] Pathophysiology [ edit ] Radiation retinopathy is very similar to other vascular diseases. Diabetes and radiation primarily damage the retinal capillaries.[en.wikipedia.org]
  • Comprehensively updated to reflect everything you need to know regarding retinal diagnosis, treatment, development, structure, function, and pathophysiology, this monumental ophthalmology reference work equips you with expert answers to virtually any[books.google.com]
  • Pathophysiology Although it is not entirely clear how ionizing radiation causes radiation retinopathy, the primary site of damage appears to be the endothelial cells of the retinal and optic nerve vasculature. 2, 3, 4, 5, 6 Although the neural retina,[entokey.com]

Prevention

  • Recent work has been directed towards prevention of radiation retinopathy prior to its development. This has been done with preventive scatter laser and intravitreal bevacizumab therapy.[ncbi.nlm.nih.gov]

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