Factors Associated with Occurrence of Radiation-induced Optic Neuropathy at "Safe" Radiation Dosage.

MedStar author(s):
Citation: Seminars in Ophthalmology. 33(4):581-588, 2018.PMID: 28704158Institution: MedStar Washington Hospital CenterDepartment: OphthalmologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Optic Neuritis/ep [Epidemiology] | *Radiation Injuries/ep [Epidemiology] | *Radiosurgery/ae [Adverse Effects] | Adolescent | Adult | Aged | Dose-Response Relationship, Radiation | Female | Follow-Up Studies | Humans | Incidence | Male | Middle Aged | Nerve Fibers/pa [Pathology] | Nerve Fibers/re [Radiation Effects] | Optic Nerve/dg [Diagnostic Imaging] | Optic Nerve/re [Radiation Effects] | Optic Neuritis/di [Diagnosis] | Optic Neuritis/et [Etiology] | Pituitary Neoplasms/rt [Radiotherapy] | Radiation Dosage | Radiation Injuries/di [Diagnosis] | Radiation Injuries/et [Etiology] | Retrospective Studies | Risk Factors | United States/ep [Epidemiology] | Young AdultYear: 2017ISSN:
  • 0882-0538
Name of journal: Seminars in ophthalmologyAbstract: BACKGROUND: Radiation-induced optic neuropathy (RION) is a rare, and often visually devastating, complication of radiation therapy (RT) near the anterior visual pathways.CONCLUSION: RION can occur at doses below published "safe" thresholds and with different RT modalities. Smoking and hypertension might be risk factors for RION.METHODS: A retrospective case series of patients who developed RION at a tertiary medical center, followed by a case-control study comparing RION cases with matched controls who received RT.RESULTS: Thirteen patients (18 eyes) with RION were identified. Radiation modalities included external beam photon radiation, whole brain radiation, stereotactic radiosurgery, proton beam, and unknown. Most patients received doses below published "safe" thresholds (<55 Gy; <8-10 Gy for stereotactic radiosurgery). There was no statistically significant difference in prevalence of vasculopathic factors between cases and controls; on subgroup analysis in three patients who received surprisingly low radiation doses, smoking (p=0.05) and hypertension (p=0.02) appeared more prevalent.All authors: Alonso-Basanta M, Doroslovacki P, Liu GT, Shindler KS, Tamhankar MA, Ying GSOriginally published: Seminars in Ophthalmology. :1-8, 2017 Jul 13Fiscal year: FY2018Digital Object Identifier: Date added to catalog: 2017-07-24
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Journal Article MedStar Authors Catalog Article 28704158 Available 28704158

BACKGROUND: Radiation-induced optic neuropathy (RION) is a rare, and often visually devastating, complication of radiation therapy (RT) near the anterior visual pathways.

CONCLUSION: RION can occur at doses below published "safe" thresholds and with different RT modalities. Smoking and hypertension might be risk factors for RION.

METHODS: A retrospective case series of patients who developed RION at a tertiary medical center, followed by a case-control study comparing RION cases with matched controls who received RT.

RESULTS: Thirteen patients (18 eyes) with RION were identified. Radiation modalities included external beam photon radiation, whole brain radiation, stereotactic radiosurgery, proton beam, and unknown. Most patients received doses below published "safe" thresholds (<55 Gy; <8-10 Gy for stereotactic radiosurgery). There was no statistically significant difference in prevalence of vasculopathic factors between cases and controls; on subgroup analysis in three patients who received surprisingly low radiation doses, smoking (p=0.05) and hypertension (p=0.02) appeared more prevalent.

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