Purpose:To observe the clinical and imaging characteristics of radiation-induced optic neuropathy(RION).Methods:We retrospectively reviewed the clinical data of 43 patients(69 eyes)who were diagnosed with RION at the ...Purpose:To observe the clinical and imaging characteristics of radiation-induced optic neuropathy(RION).Methods:We retrospectively reviewed the clinical data of 43 patients(69 eyes)who were diagnosed with RION at the Chinese PLA General Hospital from 2010 to 2021.Results:The latency from radiotherapy to onset of visual loss ranged from 1 to 132(36.33±30.48)months.Optic disc pallor and optic disc edema were found in 27.0%(10/37)and 8.1%(3/37)of the eyes,respectively,within 2 months.After treatment,the best corrected visual acuity(BCVA)was restored in 24.6%(17/69)of the eyes and the final BCVA improved in 13.0%(9/69)of the eyes.An 82.5%(33/40)of the eyes with magnetic resonance imaging(MRI)showed enhancement of the affected optic nerve,mostly(69.7%)in the intracranial segment,and 36.4%(12/33)of the eyes with expansion and T2-high signals also showed enhancement of the affected optic nerve.The superior retinal nerve fiber layer(RNFL)and the outer circle superior quadrant(OS)of the inner limiting membrane to retinal pigment epithelium(ILM-RPE)layer thinned significantly during the first month.The center of the ILM-RPE layer thickened significantly during the first two months and the inner circle temporal quadrant(IT)of the ILM-RPE layer thickened significantly from the third to sixth month.The RNFL thinned significantly after 6 months except for the temporal quadrant,and the average inner circle superior quadrant(IS)and outer circle of the ILM-RPE layer thinned significantly after 6 months.There was no significant difference between hyperbaric oxygen therapy(HBOT)and high-dose intravenous methylprednisolone(IVMP)therapy in improving BCVA recovery or final BCVA(P>0.05).Conclusions:The structural damage of the RNFL and ILM-RPE layer occurred during the first month,the RNFL showed progressive thinning during the follow-up period,while the ILM-RPE layer showed thinning during the first month,thickening from the third to sixth month,and thinning after 6 months.There was a discrete region of enhancement of the optic nerve,often with expansion and high-T2 signals on MRI.HBOT and high-dose IVMP therapy were hardly effective for treating RION in the non-acute stage.展开更多
基金supported by the National Key Research and Development Program. (Project code:2018YFE0113900 to S⋅W.)the National Natural Science Foundation of China (Project code:81870662 to S⋅W.)on the study.
文摘Purpose:To observe the clinical and imaging characteristics of radiation-induced optic neuropathy(RION).Methods:We retrospectively reviewed the clinical data of 43 patients(69 eyes)who were diagnosed with RION at the Chinese PLA General Hospital from 2010 to 2021.Results:The latency from radiotherapy to onset of visual loss ranged from 1 to 132(36.33±30.48)months.Optic disc pallor and optic disc edema were found in 27.0%(10/37)and 8.1%(3/37)of the eyes,respectively,within 2 months.After treatment,the best corrected visual acuity(BCVA)was restored in 24.6%(17/69)of the eyes and the final BCVA improved in 13.0%(9/69)of the eyes.An 82.5%(33/40)of the eyes with magnetic resonance imaging(MRI)showed enhancement of the affected optic nerve,mostly(69.7%)in the intracranial segment,and 36.4%(12/33)of the eyes with expansion and T2-high signals also showed enhancement of the affected optic nerve.The superior retinal nerve fiber layer(RNFL)and the outer circle superior quadrant(OS)of the inner limiting membrane to retinal pigment epithelium(ILM-RPE)layer thinned significantly during the first month.The center of the ILM-RPE layer thickened significantly during the first two months and the inner circle temporal quadrant(IT)of the ILM-RPE layer thickened significantly from the third to sixth month.The RNFL thinned significantly after 6 months except for the temporal quadrant,and the average inner circle superior quadrant(IS)and outer circle of the ILM-RPE layer thinned significantly after 6 months.There was no significant difference between hyperbaric oxygen therapy(HBOT)and high-dose intravenous methylprednisolone(IVMP)therapy in improving BCVA recovery or final BCVA(P>0.05).Conclusions:The structural damage of the RNFL and ILM-RPE layer occurred during the first month,the RNFL showed progressive thinning during the follow-up period,while the ILM-RPE layer showed thinning during the first month,thickening from the third to sixth month,and thinning after 6 months.There was a discrete region of enhancement of the optic nerve,often with expansion and high-T2 signals on MRI.HBOT and high-dose IVMP therapy were hardly effective for treating RION in the non-acute stage.
