ABSTRACT
RATIONALE: The best treatment protocol for radiation maculopathy in children has not been determined. The purpose of this study was to determine the effect of photodynamic therapy (PDT) on radiation maculopathy. PATIENT CONCERNS: An 11-year-old boy who was originally diagnosed with orbital rhabdomyosarcoma when he was 1âyear old, in October 2008. The lesion improved after peripheral blood stem cell transplantation, chemotherapy and radiation therapy. A cataract was detected in his right eye in May 2011, and he underwent cataract surgery in July 2011. Continuous amblyopia training maintained his visual acuity in his right eye. In January 2017, his visual acuity was reduced and macular edema was detected with optical coherence tomography. DIAGNOSES: We diagnosed radiation maculopathy, from the history of radiation therapy, macular edema by optical coherence tomography, and hyperfluorescent site by fluorescein angiography. INTERVENTIONS: We performed PDT in June 2017. OUTCOMES: Treatment with PDT improved macular edema and his visual acuity. LESSONS: Radiation retinopathy is progressive disorder with poor prognosis. PDT could be considered to treat radiation maculopathy.
Subject(s)
Macular Edema/therapy , Photochemotherapy/methods , Radiation Injuries/complications , Child , Humans , Macular Edema/diagnostic imaging , Macular Edema/etiology , Macular Edema/pathology , Male , Radiation Injuries/diagnosis , Rhabdomyosarcoma/radiotherapyABSTRACT
We examined responsiveness to ripasudil as a potential factor for predicting the effect of selective laser trabeculoplasty (SLT) when performed for primary open-angle glaucoma (POAG). A total of 70 eyes with no history of glaucoma surgery underwent SLT between January 2015 and June 2019. Patients were divided into two groups, with an intraocular pressure (IOP) decrease of 15% or more due to ripasudil administration before SLT defined as the effective group, while an IOP decrease of less than 15% was defined as the non-effective group. Kaplan-Meier survival analysis was performed. A Cox proportional hazards model assessed the influence of baseline factors on the success. Of the 70 eyes evaluated, treatments were effective in 22 and non-effective in 48. Postoperatively, both groups exhibited IOP reductions for up to 24 months. Success ratios at 12 and 24 months after SLT were 43.5% and 18.5% in the effective versus 24.9% and 9.3% in the non-effective group, which were significantly higher in the effective group (P = 0.03). Presence of a ripasudil effective eye (P = 0.03) was associated with treatment success. Responsiveness to ripasudil may be useful in predicting the therapeutic effect of SLT.
