Current treatments and preventive strategies for radiation retinopathy.
OBJECTIVE
Radiation retinopathy remains a devastating cause of visual morbidity in patients undergoing radiation for globe, orbit, and head and neck malignancies. This review discusses the recent efforts of several authors to treat radiation retinopathy once it has developed and efforts to prevent its development with early aggressive management.


RESULTS
Intravitreal anti-vascular endothelial growth factor agents and intravitreal steroid agents have been used to successfully treat radiation-induced macular edema and neovascular events secondary to radiation retinopathy. The visual outcomes, however, have varied. Recent work has been directed towards prevention of radiation retinopathy prior to its development. This has been done with preventive scatter laser and intravitreal bevacizumab therapy. Effective customization of radiation dose to the tumor has also reduced some collateral radiation damage. Preventive vitrectomy and silicone oil placement at the time of plaque brachytherapy may shield normal ocular structures from radiation injury.


CONCLUSIONS
Radiation retinopathy remains a major source of visual morbidity following radiotherapy for malignancies. Promising, albeit unproven, new therapies and preventive efforts may ameliorate the negative visual outcomes.
Tennessee Retina, 345 23rd Ave, N #350, Nashville, TN 37203, USA.
David
D
Reichstein
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D001918:Brachytherapy / Q000009:adverse effects*; D005134:Eye Neoplasms / Q000532:radiotherapy; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D011832:Radiation Injuries / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D011835:Radiation Protection / Q000379:methods*; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab