title: Late effect of external eye irradiation on choroidal circulation.
abstract: OBJECTIVE
  To report two cases of atypical late onset radiation chorioretinopathy occurring 15 and 25 years post exposure and the indocyanine green (ICG) angiographic findings in these patients.
  
  
  METHODS
  Clinical examination and imaging including fluorescein and ICG angiography were performed.
  
  
  RESULTS
  Fundus examination of the first patient revealed microangiopathy with intraretinal hemorrhages, lipid exudation, telangiectatic and aneurysmal capillary changes. Indocyanine green angiography showed an apparent chorioretinal anastomosis and delayed perfusion of the choriocapillaris. Fundus examination of the second patient revealed a pigment epithelial detachment and retinal pigment epithelial changes. Indocyanine green angiography showed atypical, tortuous, dilated, choroidal vessels as well as areas of hypoperfusion. Both patients had multiple dot-like hyperfluorescent spots in the midphase of the ICG angiogram.
  
  
  CONCLUSIONS
  External radiation exposure may lead to both retinal and choroidal alterations which may be independent events and which may manifest after a long period of quiescence. Furthermore, ICG angiography appears to be a useful diagnostic tool to study the alterations of the choroid following external eye irradiation.
authors.affiliation: The Vitreous-Retina-Macula Consultants of New York, and LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, 460 Park Avenue, New York, NY 10022, USA.
authors.forename: E
authors.initials: E
authors.lastname: Peiretti
authors.forename: J S
authors.initials: JS
authors.lastname: Slakter
authors.forename: S
authors.initials: S
authors.lastname: Wu
authors.forename: R
authors.initials: R
authors.lastname: Iranmanesh
authors.forename: L A
authors.initials: LA
authors.lastname: Yannuzzi
mesh_terms: D001918:Brachytherapy / Q000009:adverse effects*; D002829:Choroid / Q000098:blood supply* / Q000528:radiation effects*; D015862:Choroid Diseases / Q000175:diagnosis / Q000209:etiology*; D004396:Coloring Agents; D005134:Eye Neoplasms / Q000532:radiotherapy; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007766:Lacrimal Apparatus Diseases / Q000532:radiotherapy; D008444:Maxillary Sinus Neoplasms / Q000532:radiotherapy; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D012039:Regional Blood Flow / Q000528:radiation effects; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green