Classification and treatment of radiation maculopathy.
OBJECTIVE
Radiation maculopathy is a sight-limiting consequence of radiotherapy in the management of uveal melanoma and other intraocular tumors. In this review, we consider clinical, fluorescein angiographic and optical coherence tomographic findings, propose a classification for radiation maculopathy and discuss the management of this condition.


RESULTS
Radiation macular edema (RME) can be classified by optical coherence tomography into noncystoid or cystoid edema, with foveolar or extrafoveolar involvement. Optical coherence tomographic grading of RME has been found to correlate with visual acuity. Focal argon laser might have some limited benefit in the treatment of RME. Intravitreal triamcinolone and intravitreal antivascular endothelial growth factor agents can be of short-term benefit in the treatment of RME. In a randomized controlled trial, periocular triamcinolone significantly reduced rates of RME and vision loss up to 18 months following plaque radiotherapy for uveal melanoma.


CONCLUSIONS
Currently, there is no proven treatment for established RME, though periocular triamcinolone has been shown to have a preventive benefit. An accepted classification system for radiation maculopathy would be of benefit in planning and comparing future treatment trials.
Horgan
Noel
N
Royal Victoria Eye and Ear Hospital, Dublin, Ireland. Noel.Horgan@rveeh.ie
Shields
Carol L
CL
Mashayekhi
Arman
A
Shields
Jerry A
JA
D005451:Fluorescein Angiography; D006801:Humans; D011832:Radiation Injuries / Q000145:classification* / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects*; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000145:classification* / Q000209:etiology / Q000628:therapy*; D041623:Tomography, Optical Coherence; D014604:Uveal Neoplasms / Q000532:radiotherapy