Diagnosis and treatment characteristics of radioactive optic neuropathy

Abstract:

AIM: To explore the diagnosis and treatment methods of radioaction-induced optic neuritis(RION)through the clinical dates of 17 patients.

METHODS: It was a retrospective case series study. From August 2008 to October 2013, 17 cases(24 eyes)of Rion clinical dates from Chinese PLA General Hospital were studied. The diagnosis methods including visual acuity, pupil, fundus, visual field, fundus fluorescein angiography(FFA), visual electrophysiological testing, and head MRI. To analysis the clinical date of patients with diagnosis of RION by statistical description.

RESULTS: The deterioration degree of vision: 13 eyes were classified as Ⅳ, 9 eyes as Ⅲ, 2 eyes as Ⅱ. Ten eyes RAPD(+), visual electrophysiology is extinguished. The retina of 5 eyes showed flame hemorrhages and cotton wool spots exudation. Optic nerve head edema in one eye. T1-weighted MRI enhanced in 19 eyes which showed optic nerve of the intracranial and intratubal segments abnormal changed, optic chiasm and pituitary stalk signal abnormalities and enhancement of the optic nerve. Tortuous optic nerves and rough edges were observed in 5 eyes. Treatment effect: 4 eyes of visual acuity improved, 1 eye from blindness to light perception,1 eye from 0.08 to 0.2, 1 eye from 0.4 to 0.6,1 eye from 0.04 to 0.15, the rest of the cases did not see any improvement.

CONCLUSION: The unique clinical manifestation of RION can provide objective basis for clinical diagnosis in time, but there have not been proven any effective treatments.

Key words:radioaction-induced optic neuritis; clinical characteristics; treatments