By Paul T. Finger, MD
Dr. Finger uses laser photocoagulation to prevent radiation related retinopathy, maculopathy, and loss of vision. As published in the British Journal of Ophthalmology, Drs. Finger and Kurli found that eyes with posterior choroidal melanomas were more likely to develop sight-threatening radiation retinopathy. In that series, 50 patients were treated with sector scatter laser photocoagulation to clinically evident radiation retinopathy. A second group of patients (considered to be “high risk” to develop radiation retinopathy) were also treated with laser.
In this study, laser photocoagulation improved radiation retinopathy in 29 (64.4%) of the 45 patients treated after the onset of radiation retinopathy (17 with only retinopathy, 10 with a combination of retinopathy and maculopathy, and two with only maculopathy). Of the 16 patients who received laser treatment before clinical evidence of retinopathy, only 1 developed radiation maculopathy and two retinopathy without maculopathy (all three responded to additional laser photocoagulation).
None of the patients in the prophylactic laser group lost more than three lines of vision as a result of maculopathy.
Sector scatter argon laser photocoagulation can be used to induce regression of radiation retinopathy. Though early treatment of radiation retinopathy appears to be more effective, a more long term and prospective randomized study should be performed.