Radiation Retinopathy—A Review of Past and Current Treatment Strategies

Radiation retinopathy is a common and devastating visual side effect of radiation therapy for uveal melanoma and other ocular cancers. While the Collaborative Ocular Melanoma Study demonstrated that plaque brachytherapy is a great alternative for treatment of ocular cancers, many patients develop a visual acuity of 20/200, or worse, with rare improvement after observation of disease. This poor vision emerges from radiation scatter, which can cause damage to the retina and the optic nerve with symptoms similar to other retinal vascular diseases, such as diabetic retinopathy and neovascular age-related macular degeneration. Disease symptoms can develop between 6 months and 3 years post-treatment. Several treatment options have been explored to slow or stop the progression of this retinopathy, including laser, surgical, and pharmacological treatments. Nevertheless, despite the significant visual loss caused by radiation retinopathy, there are currently no US Food and Drug Administration-approved treatments for the disease. This article will review the history of radiation retinopathy treatment and discuss recent prospective studies in anti-vascular endothelial growth factor treatment.