Proliferative radiation retinopathy.

OBJECTIVES: To compare proliferative radiation retinopathy (PRR) with nonproliferative radiation retinopathy (NPRR) and to assess the outcome of panretinal photocoagulation treatment for PRR. METHODS: We reviewed the medical records, fundus photographs, and fluorescein angiograms of 10 patients (14 eyes) with PRR, which was diagnosed in a tertiary referral center during a 20-year period. The collected data included the following: the indications for radiation treatment, radiotherapy technique used, dose and fractions of radiation, visual acuity, indications for photocoagulation treatment, photocoagulation technique used, and response to treatment. Comparisons were made with data from 17 patients (27 eyes) with NPRR, which had not progressed to PRR during the course of this study. RESULTS: The initial visual acuity of the 14 eyes with PRR ranged from 20/20 to hand motion; these eyes had a median visual acuity of 20/90. The initial visual acuity of the 27 eyes with NPRR ranged from 20/15 to 20/400; these eyes had a median visual acuity of 20/25. Five (36%) of the eyes with PRR and 4 (15%) of the eyes with NPRR (P = .35) had a visual acuity of 20/200 or worse. After a mean follow-up time of 75 months for the eyes with PRR and 51 months for the eyes with NPRR, the median visual acuities were 20/400 and 20/50, respectively; 12 (86%) of the 14 eyes with PRR had a visual acuity of 20/200 or worse vs 7 (26%) of the 27 eyes with NPRR (P < .007). The new vessels had resolved in 10 (91%) of the 11 eyes that were treated with panretinal photocoagulation for PRR. CONCLUSIONS: Eyes with PRR have a poor prognosis for retaining and regaining good central vision. Panretinal photocoagulation seems to have long-term effectiveness in decreasing the proliferation of new vessels due to complications of radiation treatment.

Organizational age norms: why is it so hard to know one when you see one?

Scholars believe that age norms, defined here as widely shared judgments of the standard or typical ages of individuals holding a role or status within a given context, circumscribe behavior in all human societies. Admonitions such as "act your age" indicate that we expect older people to conduct themselves differently from younger people. Laws codify society's judgments of when people are old enough to vote and purchase alcoholic beverages. Work organizations have informal rules about typical ages for promotion. Yet, despite the centrality of age norms to human interaction, we know very little about them. Age norms seem easy to observe, but they have proved difficult to define and measure. Moreover, although many scholars consider age norms in a societal context, few examine them in other structured settings, such as communities or work organizations. This article explores theoretical and measurement issues that have impeded age norm studies, and presents one approach to their resolution using data from three work organizations.

Photocoagulation treatment for clinically significant radiation macular oedema.

Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 preoperatively to 20/90 at the initial postoperative examination (mean follow up 5 months) and to 20/75 at the final postoperative examination (mean follow up 39 months). At the final postoperative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO.