Commnunications Post - radiation retinopathy A fluorescence fundus angiographic study

Irradiation of the posterior segment of the eye resulting from radiotherapy either of local ocular lesions (e.g. retinoblastoma or malignant melanoma of the choroid) or of extraocular lesions of the adjacent regions (e.g. carcinoma of the antrum and nose, rodent ulcer of the face, squamous cell carcinoma of eyelids, etc.) has been known to produce delayed retinal vascular changes which develop many months or years after the actual irradiation, and may cause disturbances of vision. Stallard (I933, 1936) first reported these changes in a case of retinoblastoma treated by implantation of radon seeds. He found a circinate type of retinopathy with retinal haemorrhages and exudates, oedema of the optic disc, and sheathing of the central retinal vessels 20 months after irradiation, which ultimately caused optic atrophy. Post-radiation retinal vascular lesions have since been reported by many authors, including Foster Moore (I 935), Pillat (I 935), Renard and Duriez (I 949), Martin and Reese (1942, 1945), Fry (1952), Cogan (I950, 1958), Stallard (95 96i, I966), Perrers-Taylor, Brinkley, and Reynolds (i965), Howard (I966), Chee (I968), Gass (I968), MacFaul and Bedford (1970), and Bedford, Bedotto, and MacFaul (1970). The use of fluorescence fundus angiography in various types of retinopathy in the recent past has given us hitherto unknown information on the subject. A brief account of fluorescence fundus angiographic findings in post-radiation retinopathy has previously been reported in only two cases (Gass, I 968, and Chee, I 968 the same cases being reported by the two authors). Recently, post-radiation retinopathly was noticed in three cases of malignant melanoma of the choroid treated by Cobalt-6o application at Moorfields Eye Hospital, London (Bedford and others, I970). These three cases have been investigated by fluorescence fundus angiography. TIhis study has revealed some interesting retinal vascular changes which are reported in detail in this paper. A pattern of post-radiation retinopathy based on these findings is described, as no such detailed account on the subject is available in the literature.