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Current treatments for radiation retinopathy

Abstract

Background. To review the currently available therapeutic modalities for radiation retinopathy (RR), including newer investigational interventions directed towards specific aspects of the pathophysiology of this refractory complication. Methods. A review of the literature encompassing the pathogenesis of RR and the current therapeutic modalities available was performed. Results. RR is a chronic and progressive condition that results from exposure to any source of radiation. It might be secondary to radiation treatment of intraocular tumors such as choroidal melanomas, retinoblastomas, and choroidal metastasis, or from unavoidable exposure to excessive radiation from the treatment of extraocular tumors like cephalic, nasopharyngeal, orbital, and paranasal malignancies. After the results of the Collaborative Ocular Melanoma Study, most of the choroidal melanomas are being treated with plaque brachytherapy increasing by that the incidence of this radiation complication. RR has been reported to occur in as many as 60% of eyes treated with plaque radiation, with higher rates associated with larger tumors. Initially, the condition manifests as a radiation vasculopathy clinically seen as microaneurysms and telangiectasis, with posterior development of retinal hard exudates and hemorrhages, macular edema, neovascularization and tractional retinal detachment. Regrettably, the management of these eyes remains limited. Photodynamic therapy, laser photocoagulation, oral pentoxyphylline and hyperbaric  More>>
Authors:
Giuliari, Gian Paolo; Simpson, E. Rand (Princess Margaret Hospital, Univ. of Toronto, Dept. of Ophthalmology and Vision Sciences, Toronto (Canada)), e-mail: gpgiuliari@gmail.com; Sadaka, Ama; [1]  Hinkle, David M [2] 
  1. Schepens Eye Research Inst., Boston, MA (United States)
  2. Massachusetts Eye Research and Surgery Institution, Cambridge, MA (United States)
Publication Date:
Jan 15, 2011
Product Type:
Journal Article
Resource Relation:
Journal Name: Acta Oncologica (Stockholm) (online); Journal Volume: 50; Journal Issue: 1; Other Information: 10.3109/0284186X.2010.500299
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; NEOPLASMS; BIOLOGICAL RADIATION EFFECTS; SIDE EFFECTS; EYES; REVIEWS; RETINA
OSTI ID:
1004325
Country of Origin:
Sweden
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1651-226X; TRN: SE1108021
Availability:
Available from DOI: http://dx.doi.org/10.3109/0284186X.2010.500299
Submitting Site:
SWDN
Size:
page(s) 6-13
Announcement Date:
Feb 07, 2011

Citation Formats

Giuliari, Gian Paolo, Simpson, E. Rand (Princess Margaret Hospital, Univ. of Toronto, Dept. of Ophthalmology and Vision Sciences, Toronto (Canada)), e-mail: gpgiuliari@gmail.com, Sadaka, Ama, and Hinkle, David M. Current treatments for radiation retinopathy. Sweden: N. p., 2011. Web. doi:10.3109/0284186X.2010.500299.
Giuliari, Gian Paolo, Simpson, E. Rand (Princess Margaret Hospital, Univ. of Toronto, Dept. of Ophthalmology and Vision Sciences, Toronto (Canada)), e-mail: gpgiuliari@gmail.com, Sadaka, Ama, & Hinkle, David M. Current treatments for radiation retinopathy. Sweden. doi:10.3109/0284186X.2010.500299.
Giuliari, Gian Paolo, Simpson, E. Rand (Princess Margaret Hospital, Univ. of Toronto, Dept. of Ophthalmology and Vision Sciences, Toronto (Canada)), e-mail: gpgiuliari@gmail.com, Sadaka, Ama, and Hinkle, David M. 2011. "Current treatments for radiation retinopathy." Sweden. doi:10.3109/0284186X.2010.500299. https://www.osti.gov/servlets/purl/10.3109/0284186X.2010.500299.
@misc{etde_1004325,
title = {Current treatments for radiation retinopathy}
author = {Giuliari, Gian Paolo, Simpson, E. Rand (Princess Margaret Hospital, Univ. of Toronto, Dept. of Ophthalmology and Vision Sciences, Toronto (Canada)), e-mail: gpgiuliari@gmail.com, Sadaka, Ama, and Hinkle, David M}
abstractNote = {Background. To review the currently available therapeutic modalities for radiation retinopathy (RR), including newer investigational interventions directed towards specific aspects of the pathophysiology of this refractory complication. Methods. A review of the literature encompassing the pathogenesis of RR and the current therapeutic modalities available was performed. Results. RR is a chronic and progressive condition that results from exposure to any source of radiation. It might be secondary to radiation treatment of intraocular tumors such as choroidal melanomas, retinoblastomas, and choroidal metastasis, or from unavoidable exposure to excessive radiation from the treatment of extraocular tumors like cephalic, nasopharyngeal, orbital, and paranasal malignancies. After the results of the Collaborative Ocular Melanoma Study, most of the choroidal melanomas are being treated with plaque brachytherapy increasing by that the incidence of this radiation complication. RR has been reported to occur in as many as 60% of eyes treated with plaque radiation, with higher rates associated with larger tumors. Initially, the condition manifests as a radiation vasculopathy clinically seen as microaneurysms and telangiectasis, with posterior development of retinal hard exudates and hemorrhages, macular edema, neovascularization and tractional retinal detachment. Regrettably, the management of these eyes remains limited. Photodynamic therapy, laser photocoagulation, oral pentoxyphylline and hyperbaric oxygen have been attempted as treatment modalities with inconclusive results. Intravitreal injections of anti-vascular endothelial growth factor such as bevacizumab, ranibizumab and pegaptanib sodium have been recently used, also with variable results. Discussion. RR is a common vision threatening complication following radiation therapy. The available therapeutic options are limited and show unsatisfactory results. Further large investigative studies are required for developing better therapeutic as well as preventive treatment strategies}
doi = {10.3109/0284186X.2010.500299}
journal = {Acta Oncologica (Stockholm) (online)}
issue = {1}
volume = {50}
place = {Sweden}
year = {2011}
month = {Jan}
}