This 65YO male presented for evaluation for cataract surgery. He underwent external beam radiation for throat cancer, predominantly on the right side, 20 years earlier. Vision was hand motion OD and 20/200 OS.
Color photography OD shows severe panretinal ischemia with the major vessels showing absent blood columns except for some abnormal preserved vessels with anastomoses just superotemporal to the nerve. OCT shows temporal inner retinal atrophy. The left posterior pole appears more normal with severe more peripheral ischemia. Fluorescein angiography confirms the profound ischemia noted funduscopically.
Learning Points:
Radiation retinopathy usually occurs 3 months to 3 years following external beam radiation or plaque radiotherapy. The ocular findings closely resemble those seen with diabetic retinopathy. Radiation optic neuropathy can also develop (Carey et al, Br J Ophthalmol 2023;107:743-749) .
Panretinal photocoagulation was recommended for the right eye.
