Proliferative radiation retinopathy
J. L. Kinyoun, B. S. Lawrence and W. E. Barlow
Department of Ophthalmology, University of Washington, Seattle, USA.
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.
