Radiation retinopathy caused by low dose irradiation and antithyroid drug-induced systemic vasculitis.
BACKGROUND
We report on a patient with Graves' disease with radiation retinopathy caused by low-dose irradiation and antithyroid drug-induced antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis.


METHODS
A 38-year-old woman with Graves' disease presented with bilateral blurred vision, microaneurysms, telangiectasia, and macular edema. The patient was examined by ophthalmoscopy and fluorescein angiography, and radiation retinopathy was diagnosed.


METHODS
The patient had been treated with low-dose irradiation for her Graves' ophthalmopathy a few years earlier. She also had ANCA-positive vasculitis induced by the antithyroid drug (propylthiouracil, PTU) that had been prescribed for her at that time. Because of multiple avascular areas on both retinas, she was treated by intensive retinal photocoagulation to control progressive retinopathy.


CONCLUSIONS
The radiation doses used to treat Graves' disease ophthalmopathy are low. Nevertheless, there is still a risk of radiation retinopathy developing in patients with PTU-induced ANCA-positive vasculitis.
Sonoda
Koh-Hei
KH
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. sonodak@med.kyushu-u.ac.jp
Yamamoto
Masahiro
M
Ishibashi
Tatsuro
T
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D013956:Antithyroid Agents / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D006111:Graves Disease / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D009887:Ophthalmoscopy; D011441:Propylthiouracil / Q000009:adverse effects*; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D014657:Vasculitis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology
D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D011441:Propylthiouracil