Efficacy of photocoagulation alone or combined with intravitreal Bevacizumab for radiation retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM:To evaluate the efficacy of photocoagulation alone or combined with intravitreal Bevacizumab for radiation retinopathy ( RR) .?METHODS: There were 43 patients ( 43 eyes ) with RR were collected at the Fifth Affiliated Hospital Sun Yet-Sen University between Jan.2009 and Jan.2014.Twenty-one patients received the photocoagulation treatment combined with intravitreal bevacizumab and 22 patients received the treatment of photocoagulation alone.All the patients would complete ophthalmologic examinations, including best -corrected visual acuity ( BCVA ) , intraocular pressure, optical coherence tomography, fundus fluorescein angiography before and after the treatment.?RESULTS:BCVA:In monotherapy group, there were no statistically difference about BCVA before and after treatment ( P>0.05).In combined therapy group, the BCVA had been increasing gradually in 2wk, 1, 3, 6mo after treatment ( P 0.05).In the comparison of BCVA in these two groups in 2wk, 1, 3, 6mo after treatment, the combined therapy group were better than monotherapy group in each time point (P0.05).Central macular thickness (CMT):in monotherapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment ( P 0.05).In combined therapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment ( P0.05).In the comparison of CMT between these two groups in the 2wk, 1, 3, 6mo after treatment, those of combined therapy group were thinner and difference were statistically significant ( P 0.05).? CONCLUSION: Photocoagulation combined with intravitreal bevacizumab for the treatment of radiation retinopathy both have an effect on reducing the macular edema in a short time (6mo).But the long-term efficacy is poor.

Current research in radiation retinopathy / 中华实验眼科杂志

Radiation retinopathy is a kind of retinopathy after expose to radiation sources or radiotherapy.In China,it occurs mostly after radiotherapy for nasopharyngeal carcinoma.With the development of radiation equipment and radiotherapy technique,the target of treatment is improved and side effects decreased.However,better curative effect may bring longer surviving time and higher incidence of radiation retinopathy eventually.Radiation retinopathy is easily ignored or misdiagnosed as its fundus change is similar to that of some common retinal vascular diseases.Besides,there is no unified and standard treatment for radiation retinopathy.Thus,radiation retinopathy usually leads to incurable vision loss.Oculist and oncologist should pay close attention to this disease.This review focuses on the pathogenesis,clinical manifestation,assistant examination,diagnosis,differential diagnosis and therapeutic method for radiation retinopathy,especially the latest treatment advances in order to achieve early diagnosis and timely treatment.

A Case of Radiation Retinopathy of Left Eye After Radiation Therapy of Right Brain Metastasis

A 37-year-old female, who had received modified radical mastectomy for cancer of her right breast, presented with decreased visual acuity in the left eye after radiation therapy for the management of the metastasis to her right brain 14 months ago. After ocular examination, we diagnosed her as radiation retinopathy. At the time of the first visit, the corrected best visual acuity was 0.4 in the left eye, and fundus examination revealed cotton wool spots and cystoid macular edema (CME). The findings in the right eye were normal except for cotton wool spots in the superior major arch. Fluorescein angiography (FA) showed marked telangiectasia and microaneurysms in her left eye but tiny microaneurysms in her right eye. Subsequent optical coherent tomography (OCT) showed CME. We injected intravitreal triamcinolone acetonide (TA). Two weeks after treatment, the visual acuity was improved to 0.6 and the retinal thickness was decreased. Three months later, the visual acuity in the left eye was dropped to 0.3 due to the recurrence of CME, so we injected intravitreal TA again. Five months later, visual acuity was improved to 0.5 and OCT revealed the improvement of CME. The incidence of radiation retinopathy is higher in the side nearer to radiation, but careful radiation blocking is also required on the opposite side of irradiation site considering the possibility of radiation retinopathy and careful observation is required on both sides of the eyes when performing fundus examination.

An Empirical Study on Morphological Changes in Retinal Endothelial Cells in Radiation Retinopathy of Rats / 医学研究杂志

0.05).Comparison group model and normal control:detected the numbers of endothelial cells:①1 month:control group contrast with test group has no changed;②3 month:group 30Gy/N(P

Clinical Evaluation of Radiation Retinopathy

PURPOSE: To assess variable clinical findings and risk factors of radiation retinopathy and to evaluate the effects of laser photocoagulation. METHODS: We reviewed the medical charts of 55 patients who received fractionated external-beam radiation during the treatment of head and neck tumors and who had a minimum of 2 years of follow-up from January 1996 to June 2002. RESULTS: Thirteen eyes in 8 patients developed radiation retinopathy. The mean time to the onset of symptoms attributable to retinal ischemia was 28 months (range, 15 to 43 months). The most common initial visual symptom was decreased visual acuity. Retinal hemorrhages, hard exudates and cotton wool spots were frequently observed fundus findings, and capillary non-perfusion on fluorescein angiography was the invariable findings. The mean total radiation dose was significantly higher in the retinopathy positive group (66.9+/-5.7 Gy) than in the retinopathy negative group (55.4+/-15.8 Gy) (P<0.05). Laser photocoagulation was performed in nine eyes of which 7 had good prognosis for retaining and regaining good central vision at the last follow-up. CONCLUSIONS: Although radiation retinopathy is infrequent, the long-term visual outcome is good with adequate laser photocoagulation treatment when detected early by close and regular follow-up.

Radiation Retinopathy after Irradiation of Intracranial Lesion

PURPOSE: Radiation retinopathy is a slowly progressive vaso-occlusive angiopathy of the retina. The history of previous radiation exposure is very essential for the diagnosis. We report one case of radiation retinopathy after the radiation therapy for brain tumor with a good result using photocoagulation and focal laser treatment. METHODS: The chief complaint of 48 aged-female patient was a slowly progressive decrease in left visual acuity. The best corrected visual acuity of right eye was 1.0 and the best corrected visual acuity of left eye was 0.5. We got the diagnosis with a detailed history taking and fluorescein angiography. We did panretinal photocoagulation on both eyes due to non-perfused area, angiogenesis, and we did focal laser treatment on right eye due to macular edema. RESULTS: Compared with previous examination, right eye was stable without any change of fundus examination and the best corrected visual acuity of right eye was 1.0 after panretinal photocoagulation and focal laser treatment, but mild vitreous hemorrahage occurred in left eye after panretinal photocoagulation. Follow-up at 6 months after laser treatment showed that hemorrahage of left eye was absorbed more than before and we did additional photocoagulation on the peripheral retina. Follow-up at 12 months after laser treatment showed that right eye was stable, angiogenesis of left eye was regressed and best corrected visual acuity was 0.5. CONCLUSIONS: Detailed history taking and suspicion is important for the diagnosis of radiation retinopathy. It is also essential to suppress the progression of the disease with an early detection through regular examinations.

Radiation Retinopathy Following Cephalic Radiation

Radiation retinopathy is a slowly progressive vaso-occlusive microangiopathy of the retina, following irradiation of the head and the eye. Factors in the pathogenesis of this condition include total radiation dosage, proximity of the treated site to the eye, concomitant chemotherapy and preexisting vascular disorders. We present three patients of radiation retinopathy, one of who was a diabetes and two were positive for the history of concomitant chemotherpy. All the patients developed asymmetrical retinal change after the external cephalic radiation of over 3500 cGy within eleven to twenty-one months. Fluorescein angiographic findings confirmed the typical ischemic features of radiation retinopathy. As these cases show, physicians need to be aware of this vision-threatening complication following cephalic radiation, especially in the high-risk groups.