Late radiation retinopathy in a patient treated for retinoblastoma.

Abstract

We report a case of a young man who developed radiation retinopathy 12 years after irradiation for retinoblastoma. With a history of bilateral retinoblastoma, our patient presented clustered retinal teleangiectasias in the non-enucleated but treated with radiation eye. The lesions were associated with hemorrhages and gradually increasing retinal exudation that deteriorated best corrected visual acuity (BCVA) from 0.25 to 0.1. Detailed ophthalmic examination was performed incl. fl uorescein angiography (FA), indocyanine green angiography (ICG) and optical coherence tomography (OCT). The ICG highlighted the vascular anomalies that were clearly hyperfl uorescent in the late phase. After 3 sessions of focal ALC the outlined edema on Oct scans diminished and BCVA improved to 0.2. Some retinoschisis-like cystic changes remained on OCT retinal scans. The manifested changes had common features with those found in diabetic retinopathy. ICG staining of the retinal vascular anomalies was found. Radiation retinopathy may occur more than a decade following radiation treatment for retinoblastoma. Appropriate laser treatment may overcome the advancing process.