Clinical Evaluation of Radiation Retinopathy

ABSTRACT

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.