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. 1992 Nov;157(5):530–533.

Radiation retinopathy.

R W Zamber 1, J L Kinyoun 1
PMCID: PMC1022030  PMID: 1441494

Abstract

Radiation therapy is effective against many cancerous and noncancerous disease processes. As with other therapeutics, side effects must be anticipated, recognized, and managed appropriately. Radiation retinopathy is a vision-threatening complication of ocular, orbital, periorbital, facial, nasopharyngeal, and cranial irradiation. Factors that appear important in the pathogenesis of radiation retinopathy include total radiation dosage, fraction size, concomitant chemotherapy, and preexisting vascular disorders. Clinical manifestations of the disorder include macular edema and nonproliferative and proliferative retinopathy, similar to changes seen in diabetic retinopathy. Argon laser photocoagulation has proved efficacious for managing macular edema and fibrovascular proliferation in some of these patients. Ongoing basic laboratory and clinical research efforts have led to a better understanding of the pathogenesis, natural history, and treatment response of radiation retinopathy. The ultimate goal of this knowledge is to improve the prevention, recognition, and management of this vision-threatening complication.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amoaku W. M., Archer D. B. Fluorescein angiographic features, natural course and treatment of radiation retinopathy. Eye (Lond) 1990;4(Pt 5):657–667. doi: 10.1038/eye.1990.93. [DOI] [PubMed] [Google Scholar]
  2. Archer D. B., Amoaku W. M., Gardiner T. A. Radiation retinopathy--clinical, histopathological, ultrastructural and experimental correlations. Eye (Lond) 1991;5(Pt 2):239–251. doi: 10.1038/eye.1991.39. [DOI] [PubMed] [Google Scholar]
  3. Bagan S. M., Hollenhorst R. W. Radiation retinopathy after irradiation of intracranial lesions. Am J Ophthalmol. 1979 Oct;88(4):694–697. doi: 10.1016/0002-9394(79)90667-6. [DOI] [PubMed] [Google Scholar]
  4. Bedford M. A., Bedotto C., Macfaul P. A. Radiation retinopathy after the application of a cobalt plaque. Report of three cases. Br J Ophthalmol. 1970 Aug;54(8):505–509. doi: 10.1136/bjo.54.8.505. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brown G. C., Shields J. A., Sanborn G., Augsburger J. J., Savino P. J., Schatz N. J. Radiation optic neuropathy. Ophthalmology. 1982 Dec;89(12):1489–1493. doi: 10.1016/s0161-6420(82)34612-6. [DOI] [PubMed] [Google Scholar]
  6. Brown G. C., Shields J. A., Sanborn G., Augsburger J. J., Savino P. J., Schatz N. J. Radiation retinopathy. Ophthalmology. 1982 Dec;89(12):1494–1501. doi: 10.1016/s0161-6420(82)34611-4. [DOI] [PubMed] [Google Scholar]
  7. CIBIS P. A., BROWN D. V. Retinal changes following ionizing radiation. Am J Ophthalmol. 1955 Nov;40(5 Pt 2):84–88. doi: 10.1016/0002-9394(55)91840-7. [DOI] [PubMed] [Google Scholar]
  8. Chacko D. C. Considerations in the diagnosis of radiation injury. JAMA. 1981 Mar 27;245(12):1255–1258. [PubMed] [Google Scholar]
  9. Chan R. C., Shukovsky L. J. Effects of irradiation on the eye. Radiology. 1976 Sep;120(3):673–675. doi: 10.1148/120.3.673. [DOI] [PubMed] [Google Scholar]
  10. Chaudhuri P. R., Austin D. J., Rosenthal A. R. Treatment of radiation retinopathy. Br J Ophthalmol. 1981 Sep;65(9):623–625. doi: 10.1136/bjo.65.9.623. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Chee P. H. Radiation retinopathy. Am J Ophthalmol. 1968 Nov;66(5):860–865. doi: 10.1016/0002-9394(68)92800-6. [DOI] [PubMed] [Google Scholar]
  12. Egbert P. R., Donaldson S. S., Moazed K., Rosenthal A. R. Visual results and ocular complications following radiotherapy for retinoblastoma. Arch Ophthalmol. 1978 Oct;96(10):1826–1830. doi: 10.1001/archopht.1978.03910060338008. [DOI] [PubMed] [Google Scholar]
  13. Egbert P. R., Fajardo L. F., Donaldson S. S., Moazed K. Posterior ocular abnormalities after irradiation for retinoblastoma: a histopathological study. Br J Ophthalmol. 1980 Sep;64(9):660–665. doi: 10.1136/bjo.64.9.660. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Elsås T., Thorud E., Jetne V., Conradi I. S. Retinopathy after low dose irradiation for an intracranial tumor of the frontal lobe. A case report. Acta Ophthalmol (Copenh) 1988 Feb;66(1):65–68. doi: 10.1111/j.1755-3768.1988.tb08536.x. [DOI] [PubMed] [Google Scholar]
  15. Engerman R. L. Animal models of diabetic retinopathy. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1976 Jul-Aug;81(4 Pt 1):OP710–OP715. [PubMed] [Google Scholar]
  16. Gass J. D. A fluorescein angiographic study of macular dysfunction secondary to retinal vascular disease. VI. X-ray irradiation, carotid artery occlusion, collagen vascular disease, and vitritis. Arch Ophthalmol. 1968 Nov;80(5):606–617. doi: 10.1001/archopht.1968.00980050608006. [DOI] [PubMed] [Google Scholar]
  17. Guy J., Schatz N. J. Hyperbaric oxygen in the treatment of radiation-induced optic neuropathy. Ophthalmology. 1986 Aug;93(8):1083–1088. doi: 10.1016/s0161-6420(86)33617-0. [DOI] [PubMed] [Google Scholar]
  18. Harris J. R., Levene M. B. Visual complications following irradiation for pituitary adenomas and craniopharyngiomas. Radiology. 1976 Jul;120(1):167–171. doi: 10.1148/120.1.167. [DOI] [PubMed] [Google Scholar]
  19. Hayreh S. S. Post-radiation retinopathy. A fluorescence fundus angiographic study. Br J Ophthalmol. 1970 Nov;54(11):705–714. doi: 10.1136/bjo.54.11.705. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Howard G. M. Ocular effects of radiation and photocoagulation. A study of 100 globes with retinoblastoma, some of which were treated prior to enucleation. Arch Ophthalmol. 1966 Jul;76(1):7–10. doi: 10.1001/archopht.1966.03850010009004. [DOI] [PubMed] [Google Scholar]
  21. Irvine A. R., Alvarado J. A., Wara W. M., Morris B. W., Wood I. S. Radiation retinopathy: an experimental model for the ischemic--proliferative retinopathies. Trans Am Ophthalmol Soc. 1981;79:103–122. [PMC free article] [PubMed] [Google Scholar]
  22. Irvine A. R., Wood I. S. Radiation retinopathy as an experimental model for ischemic proliferative retinopathy and rubeosis iridis. Am J Ophthalmol. 1987 Jun 15;103(6):790–797. doi: 10.1016/s0002-9394(14)74395-8. [DOI] [PubMed] [Google Scholar]
  23. Kinyoun J. L., Chittum M. E., Wells C. G. Photocoagulation treatment of radiation retinopathy. Am J Ophthalmol. 1988 May 15;105(5):470–478. doi: 10.1016/0002-9394(88)90237-1. [DOI] [PubMed] [Google Scholar]
  24. Kinyoun J. L., Kalina R. E., Brower S. A., Mills R. P., Johnson R. H. Radiation retinopathy after orbital irradiation for Graves' ophthalmopathy. Arch Ophthalmol. 1984 Oct;102(10):1473–1476. doi: 10.1001/archopht.1984.01040031193016. [DOI] [PubMed] [Google Scholar]
  25. Kline L. B., Kim J. Y., Ceballos R. Radiation optic neuropathy. Ophthalmology. 1985 Aug;92(8):1118–1126. doi: 10.1016/s0161-6420(85)33898-8. [DOI] [PubMed] [Google Scholar]
  26. Lopez P. F., Sternberg P., Jr, Dabbs C. K., Vogler W. R., Crocker I., Kalin N. S. Bone marrow transplant retinopathy. Am J Ophthalmol. 1991 Dec 15;112(6):635–646. doi: 10.1016/s0002-9394(14)77269-1. [DOI] [PubMed] [Google Scholar]
  27. Macfaul P. A., Bedford M. A. Ocular complications after therapeutic irradiation. Br J Ophthalmol. 1970 Apr;54(4):237–247. doi: 10.1136/bjo.54.4.237. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Midena E., Segato T., Piermarocchi S., Corti L., Zorat P. L., Moro F. Retinopathy following radiation therapy of paranasal sinus and nasopharyngeal carcinoma. Retina. 1987 Fall;7(3):142–147. doi: 10.1097/00006982-198700730-00002. [DOI] [PubMed] [Google Scholar]
  29. Miller M. L., Goldberg S. H., Bullock J. D. Radiation retinopathy after standard radiotherapy for thyroid-related ophthalmopathy. Am J Ophthalmol. 1991 Nov 15;112(5):600–601. doi: 10.1016/s0002-9394(14)76869-2. [DOI] [PubMed] [Google Scholar]
  30. Nikoskelainen E., Joensuu M. Retinopathy after irradiation for Graves' ophthalmopathy. Lancet. 1989 Sep 16;2(8664):690–691. doi: 10.1016/s0140-6736(89)90944-6. [DOI] [PubMed] [Google Scholar]
  31. Noble K. G., Kupersmith M. J. Retinal vascular remodelling in radiation retinopathy. Br J Ophthalmol. 1984 Jul;68(7):475–478. doi: 10.1136/bjo.68.7.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Shukovsky L. J., Fletcher G. H. Retinal and optic nerve complications in a high dose irradiation technique of ethmoid sinus and nasal cavity. Radiology. 1972 Sep;104(3):629–634. doi: 10.1148/104.3.629. [DOI] [PubMed] [Google Scholar]
  33. Viebahn M., Barricks M. E., Osterloh M. D. Synergism between diabetic and radiation retinopathy: case report and review. Br J Ophthalmol. 1991 Oct;75(10):629–632. doi: 10.1136/bjo.75.10.629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Wara W. M., Irvine A. R., Neger R. E., Howes E. L., Jr, Phillips T. L. Radiation retinopathy. Int J Radiat Oncol Biol Phys. 1979 Jan;5(1):81–83. doi: 10.1016/0360-3016(79)90043-9. [DOI] [PubMed] [Google Scholar]
  35. de Schryver A., Wachtmeister L., Båryd I. Ophthalmologic observations on long-term survivors after radiotherapy for nasopharyngeal tumours. Acta Radiol Ther Phys Biol. 1971 Apr;10(2):193–209. doi: 10.3109/02841867109129756. [DOI] [PubMed] [Google Scholar]
  36. del Regato J. A. Milestones in therapeutic radiology. Front Radiat Ther Oncol. 1991;25:4–9. doi: 10.1159/000429573. [DOI] [PubMed] [Google Scholar]

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