Visual Outcomes following Pars Plan Vitrectomy for Complications of Radiation Retinopathy

Abstract

Abstract: : Purpose: To evaluate the visual outcomes in patients undergoing pars plana vitrectomy (PPV) surgery for complications of radiation retinopathy. Background: Radiation delivered to the eye or adjacent structures can lead to radiation retinopathy, which can manifest a variety of features resembling diabetic retinopathy. Persistent vitreous hemorrhage (VH) occasionally leads to the need for PPV surgery. There is limited information describing visual outcomes following PPV for complications related to radiation retinopathy. Methods: Retrospective chart review of six patients who underwent PPV for complications of radiation retinopathy. Results: Six eyes (six patients) with history of previous ocular or periocular radiation (5 with external beam and 1 with gamma knife) developed complications requiring PPV surgery. The average age was 33 years(range 6 to 48 years). Five patients required PPV for non–clearing VH and one patient for preretinal hemorrhage and tractional membranes. The preoperative visual acuity (VA) ranged from 20/300 to HM. Five of the six patients were followed in excess of one year (range 3 to 24 months; average 14.5 months). The final VA ranged from 20/80 to HM, with only one patient having VA better than 20/200 (though this patient also received hyperbaric oxygen therapy for persistent macular edema). The reasons for decreased vision postoperatively included macular non–perfusion (4 patients), persistent macular edema (1 patient), and recurrent VH (1 patient). Conclusions: Radiation retinopathy is a well known complication of radiation treatment delivered to the eye or adjacent structures. Our study suggests that patients undergoing PPV for complications of radiation retinopathy appear to have limited visual recovery after the surgery. Patients should be advised of guarded visual prognosis following surgery.

Keywords: vitreoretinal surgery • radiation therapy • clinical (human) or epidemiologic studies: outcomes/complications