First Author: F.Costales Mier SPAIN
Co Author(s): A. Mateos Hernandez L. Monje Fernandez J. Sanchez Canizal C. Plaza Laguardia N. Spagnoli Santa Cruz E. Pertejo Fernandez
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Radiation retinopathy is a sight-threatening consequence of radiotherapy, that can have an acute or delayed presentation. Our aim is to describe a radiation retinopathy case that developed an ischaemic macular atrophy, like that seen in macular telangiectasia patients.
One patient that developed radiation maculopathy, after craniofacial radiotherapy. Red-free, autofluorescence, and colour retinography was performed. OCT and A-OCT was performed on initial evaluation and follow up.
Retrospective case report.
We report a 55 year-old patient diagnosed with a parotid gland mucoepidermoid carcinoma, that had received radiation therapy over the right parotid gland tumour. One year after treatment, he referred rapid onset of metamorphopsia and progressive visual acuity loss in his right eye. He presented mild nuclear cataract on his right eye. Fundus examination showed pigment dispersion and slight capillary vascular dilation around the right temporal peri-foveal area, OCT examination showed anterior sub-ILM foveal cyst and foveal thinning, an augmented foveal avascular zone, and augmented capillary tortuosity and dilation on A-OCT, compared to his left eye which showed normal features. He remains stable, Snellen visual acuity OD 0.4 OS 1, and has not developed any other major complication at one year follow up.
Radiation maculopathy is a phenomenon that occurs after radiation exposure. Early in the clinical course can develop macular edema, and later it can develop haemorrhages, hard exudates, and ischaemic features. We can presume that radiation therapy induced ischaemic features, that can resemble macular telangiectasia, after excluding other causes and considering total radiation dosage. Fundus retinography and OCT are important tools to document and control progression on diverse maculopathies. A-OCT can allow us to visualize vascular retinal micro-structure, and to make possible to identify microvascular anomalies, and ischaemic areas.