Radiation-associated cerebral blindness.
OBJECTIVE
To report a case of blindness caused by a white-matter injury after whole brain irradiation for metastatic renal cell carcinoma.


METHODS
Case report. We performed comprehensive serial neuro-ophthalmologic examinations.


RESULTS
Four to 5 months after resection of renal cell metastasis in the left occipital cortex, interleukin-2 therapy, and whole brain irradiation with 3,000 cGy plus a 1,500-cGy boost to the posterior third of the brain, the patient developed a progressive decline in visual acuity in both eyes to hand motions. Magnetic resonance imaging disclosed signal abnormalities without mass effect in the white matter of the parietal and occipital lobes bilaterally, including the optic radiations.


CONCLUSIONS
This case is a unique example of cortical blindness secondary to radiation injury in the occipital lobes and optic radiations.
Department of Ophthalmology, Harvard Medical School and the Massachusetts Eye and Ear Infirmary, Boston 02114, USA.
H D
HD
Pomeranz
J W
JW
Henson
S
S
Lessell
D001766:Blindness / Q000209:etiology* / Q000473:pathology; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy* / Q000556:secondary; D002540:Cerebral Cortex / Q000473:pathology / Q000528:radiation effects*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects; D014792:Visual Acuity