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Post-radiation retinopathy. A fluorescence fundus angiographic study.

Sohan Singh Hayreh
- 01 Nov 1970 - 
- Vol. 54, Iss: 11, pp 705-714
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TLDR
Recently, post-radiation retinopathly was noticed in three cases of malignant melanoma of the choroid treated by Cobalt-6o application at Moorfields Eye Hospital, London (Bedford and others, I970).
Abstract
Irradiation of the posterior segment of the eye resulting from radiotherapy either of local ocular lesions (e.g. retinoblastoma or malignant melanoma of the choroid) or of extraocular lesions of the adjacent regions (e.g. carcinoma of the antrum and nose, rodent ulcer of the face, squamous cell carcinoma of eyelids, etc.) has been known to produce delayed retinal vascular changes which develop many months or years after the actual irradiation, and may cause disturbances of vision. Stallard (I933, 1936) first reported these changes in a case of retinoblastoma treated by implantation of radon seeds. He found a circinate type of retinopathy with retinal haemorrhages and exudates, oedema of the optic disc, and sheathing of the central retinal vessels 20 months after irradiation, which ultimately caused optic atrophy. Post-radiation retinal vascular lesions have since been reported by many authors, including Foster Moore (I 935), Pillat (I 935), Renard and Duriez (I 949), Martin and Reese (1942, 1945), Fry (1952), Cogan (I950, 1958), Stallard (95 96i, I966), Perrers-Taylor, Brinkley, and Reynolds (i965), Howard (I966), Chee (I968), Gass (I968), MacFaul and Bedford (1970), and Bedford, Bedotto, and MacFaul (1970). The use of fluorescence fundus angiography in various types of retinopathy in the recent past has given us hitherto unknown information on the subject. A brief account of fluorescence fundus angiographic findings in post-radiation retinopathy has previously been reported in only two cases (Gass, I 968, and Chee, I 968 the same cases being reported by the two authors). Recently, post-radiation retinopathly was noticed in three cases of malignant melanoma of the choroid treated by Cobalt-6o application at Moorfields Eye Hospital, London (Bedford and others, I970). These three cases have been investigated by fluorescence fundus angiography. TIhis study has revealed some interesting retinal vascular changes which are reported in detail in this paper. A pattern of post-radiation retinopathy based on these findings is described, as no such detailed account on the subject is available in the literature.

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Radiation retinopathy--clinical, histopathological, ultrastructural and experimental correlations.

TL;DR: Clinical, pathological and experimental studies of radiation retinopathy confirm that the primary vascular event is endothelial cell loss and capillary closure, and later photocoagulation is useful in containing or reversing microvascular incompetence and vasoproliferation in some patients with advanced radiation Retinopathy.
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The effects of irradiation on the eye and optic nerve.

TL;DR: Time-dose analyses are performed for lacrimal apparatus, retinal, and optic nerve injuries and recommendations are made regarding radiation treatment techniques and methods of reducing the risk of late injury.
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Radiation Optic Neuropathy

TL;DR: The ophthalmoscopic findings in a series of 14 eyes with radiation-induced optic neuropathy are described, and the visual acuity in certain eyes with decreased vision attributable to radiation optic Neuropathy may improve over a period of several months.
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Radiation retinopathy following plaque radiotherapy for posterior uveal melanoma.

TL;DR: Radiation Retinopathy is a common finding after plaque radiotherapy for choroidal melanoma, occurring in 42% of patients at 5 years, and the main predictors of radiation retinopathy are posterior tumor location with margin near the foveola and high radiation dose rate to the tumor base.
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Late effects of radiation on the eye and ocular adnexa

TL;DR: Radiation-induced pathophysiological and clinical changes of the various ocular structures as well as dose-response data and management of ocular complications are reviewed.
References
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Text book of ophthalmology

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Treatment of retinoblastoma (retinal glioma) surgically and by irradiation

TL;DR: The other clinical forms and stages of retinoblastoma (unilateral tumors, advanced bilateral growths with the vision irreparably destroyed by the time of admission, postoperative recurrent retin Oblastoma and widely disseminated retinOBlastoma), in the treatment of which radiation therapy as a means of conserving vision is discussed.
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