Radiation retinopathy is a result of an obliterative endarteritis of the retinal capillary system.1 The hallmark clinical finding is capillary nonperfusion, as seen on fluorescein angiography. Vascular decompensation results in the funduscopic appearance of hard and soft exudates, superficial and deep hemorrhages, microaneurysms, telangiectasia, and neovascularization. This delayed response to radiation may slowly progress although spontaneous improvement with capillary reperfusion may occur.
The following case report documents radiation retinopathy presenting as an acute central retinal artery occlusion occurring 15 months after external-beam irradiation for progressive Graves' thyroid ophthalmopathy. The more typical progressive retinal radiation appearance has developed in the fellow eye.
Report of a Case.
A 42-year-old woman noted sudden complete visual loss in the right eye. She had a history of Graves' thyroid ophthalmopathy and had external-beam irradiation to each eye 15 months prior (multiple treatments over a 3-week period with a total calculated dose of 23 Gy).
Noble KG. Central Retinal Artery Occlusion: The Presenting Sign in Radiation Retinopathy. Arch Ophthalmol. 1994;112(11):1409-1410. doi:10.1001/archopht.1994.01090230023009