PURPOSE OF REVIEW: Radiation maculopathy is a sight-limiting consequence of radiotherapy in the management of uveal melanoma and other intraocular tumors. In this review, we consider clinical, fluorescein angiographic and optical coherence tomographic findings, propose a classification for radiation maculopathy and discuss the management of this condition. RECENT FINDINGS: Radiation macular edema (RME) can be classified by optical coherence tomography into noncystoid or cystoid edema, with foveolar or extrafoveolar involvement. Optical coherence tomographic grading of RME has been found to correlate with visual acuity. Focal argon laser might have some limited benefit in the treatment of RME. Intravitreal triamcinolone and intravitreal antivascular endothelial growth factor agents can be of short-term benefit in the treatment of RME. In a randomized controlled trial, periocular triamcinolone significantly reduced rates of RME and vision loss up to 18 months following plaque radiotherapy for uveal melanoma. SUMMARY: Currently, there is no proven treatment for established RME, though periocular triamcinolone has been shown to have a preventive benefit. An accepted classification system for radiation maculopathy would be of benefit in planning and comparing future treatment trials.
PURPOSE OF REVIEW: Radiation maculopathy is a sight-limiting consequence of radiotherapy in the management of uveal melanoma and other intraocular tumors. In this review, we consider clinical, fluorescein angiographic and optical coherence tomographic findings, propose a classification for radiation maculopathy and discuss the management of this condition. RECENT FINDINGS: Radiation macular edema (RME) can be classified by optical coherence tomography into noncystoid or cystoid edema, with foveolar or extrafoveolar involvement. Optical coherence tomographic grading of RME has been found to correlate with visual acuity. Focal argon laser might have some limited benefit in the treatment of RME. Intravitreal triamcinolone and intravitreal antivascular endothelial growth factor agents can be of short-term benefit in the treatment of RME. In a randomized controlled trial, periocular triamcinolone significantly reduced rates of RME and vision loss up to 18 months following plaque radiotherapy for uveal melanoma. SUMMARY: Currently, there is no proven treatment for established RME, though periocular triamcinolone has been shown to have a preventive benefit. An accepted classification system for radiation maculopathy would be of benefit in planning and comparing future treatment trials.
Authors: Carol L Shields; Lauren A Dalvin; Michael Chang; Mehdi Mazloumi; Patricia Fortin; Mark McGarrey; Andrei Martin; Antonio Yaghy; Xiaolu Yang; Pornpattana Vichitvejpaisal; Arman Mashayekhi; Jerry A Shields Journal: JAMA Ophthalmol Date: 2020-02-01 Impact factor: 7.389
Authors: Alison H Skalet; Liang Liu; Christina Binder; Audra K Miller; Richard Crilly; Arthur Y Hung; David J Wilson; David Huang; Yali Jia Journal: Ophthalmol Retina Date: 2019-10-11
Authors: Rumana N Hussain; Sarah E Coupland; Helen Kalirai; Azzam F G Taktak; Antonio Eleuteri; Bertil E Damato; Carl Groenewald; Heinrich Heimann Journal: Cancers (Basel) Date: 2021-05-08 Impact factor: 6.639
Authors: Alejandra Bosco; Samuel D Crish; Michael R Steele; Cesar O Romero; Denise M Inman; Philip J Horner; David J Calkins; Monica L Vetter Journal: PLoS One Date: 2012-08-30 Impact factor: 3.240