Radiation-induced chorioretinal degeneration: a clinicopathological report of three cases.
BACKGROUND
With the shift in radiotherapy toward the posterior segment and with the use of lead screens to shield the anterior segment, posterior segment lesions have become more readily recognized. The purpose of this study is to highlight the effects of ionizing radiation on the choroid and to demonstrate how this can result in visual loss, particularly if the macula is involved.


METHODS
Histopathological study of three enucleated eyes of three patients who had received ionizing radiation: a 27-year-old woman who had received radiation as a child for a hemangioma of the left side of the face, a 16-year-old girl who had received radiation at age 11 years for a malignant mesenchymoma of the right maxilla, and a 4-year-old girl who had received radiation at age 1 year for a retinoblastoma of the right eye.


RESULTS
Histopathological examination of the three globes showed extensive chorioretinal degeneration, among other ocular findings. In all cases the fellow eye did not show similar chorioretinal lesions. As all three patients were relatively young, the degree of chorioretinal degeneration was considered to be secondary to radiation treatment.


CONCLUSIONS
Vascular damage from ionizing radiation is not limited to the retina. It can also affect the choroid in the form of chorioretinal degeneration. Since most of the intraocular circulation arises from the uveal vessels, chorioretinal degenerative lesions may be extensive and may even involve the macula.
Sefau
Suleiman O A
SO
Department of Ophthalmology, University of Ottawa Eye Institute, Ottawa Hospital, Ottawa. Ont.
Dorey
Michael W
MW
Brownstein
Seymour
S
Romanchuk
Ken
K
Little
John M
JM
Chisholm
Ian A
IA
D000328:Adult; D001766:Blindness / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002829:Choroid / Q000473:pathology / Q000528:radiation effects*; D015862:Choroid Diseases / Q000209:etiology* / Q000473:pathology; D015353:Eye Enucleation; D005153:Facial Neoplasms / Q000532:radiotherapy; D005260:Female; D006391:Hemangioma / Q000532:radiotherapy; D006801:Humans; D008441:Maxillary Neoplasms / Q000532:radiotherapy; D008637:Mesenchymoma / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology; D011839:Radiation, Ionizing; D012160:Retina / Q000473:pathology / Q000528:radiation effects*; D012162:Retinal Degeneration / Q000209:etiology* / Q000473:pathology; D019572:Retinal Neoplasms / Q000532:radiotherapy; D012175:Retinoblastoma / Q000532:radiotherapy