Radiation Retinopathy

Radiation Retinopathy
SALIENT FEATURES
  • Radiation retinopathy (RR), characterized as nonproliferative or proliferative, is a slowly progressive retinal vasculopathy that develops following exposure to ocular irradiation from plaque brachytherapy, external beam radiation, proton beam radiotherapy, helium ion radiotherapy, or gamma knife radiotherapy.1
  • Clinical features of RR are similar to diabetic retinopathy (DR) and develop typically within 18 months to 3 years after radiation exposure.1,2
  • Nonproliferative RR features include microaneurysms, cotton wool spots, hemorrhages, vascular occlusion, telangiectasias, exudates, and macular edema (Figure 18.1A).2
  • In contrast to early pericyte loss in DR, the primary insult in RR is early endothelial cell damage with relative preservation of pericytes.1,2
  • Endothelial cell loss in capillaries leads to microaneurysm formation, capillary occlusion with ischemia, and telangiectatic vessels or collateral vasculature at the edges of capillary occlusions.1,2
  • Proliferative RR can develop secondary to retinal ischemia. This is characterized by retinal neovascularization with possible neovascular glaucoma, vitreous hemorrhage, and/or tractional retinal detachment.3
FIGURE 18.1 A, Fundus photograph of the right eye with nonproliferative radiation retinopathy (RR) 18 months after plaque brachytherapy for choroidal melanoma-displaying hemorrhages, cotton wool spots, and microaneurysms. B, Corresponding foveal optical coherence tomography (OCT) image showing cystoid macular edema with intraretinal fluid (white asterisks).
OCT IMAGING
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May 10, 2021 | Posted by in OPHTHALMOLOGY | Comments Off on Radiation Retinopathy

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