Giant retinal telangiectasia after ophthalmic plaque radiation therapy.

PURPOSE: Radiation retinopathy is a known complication of plaque brachytherapy, characterized by progressive retinal vasculature damage. This study describes the clinical course of two cases of late post-radiation giant retinal telangiectasias, discovered in patients treated with radiation for choroidal melanomas.

METHODS

A single center chart review revealed two patients with giant retinal telangiectasis. Each patient had been treated with palladium-103 (103Pd) plaque brachytherapy for choroidal melanoma. Clinical data revealed their presentation, clinical course and treatment.

RESULTS

Giant retinal telangiectasias were associated with pre-retinal hemorrhages, exudates, and edema occurring 7 and 9 years after irradiation, with macular telangiectasia exhibiting a more fulminant course. It required both laser photocoagulation and periodic intravitreal steroid therapy; both received intravitreal anti-vascular endothelial growth factor injections. Treatment was given based on both telangiectasia activity and other radiation-induced ocular morbidities.

CONCLUSIONS

Giant retinal telangiectasias are a rare complication that may occur after ophthalmic plaque radiation therapy.