A Brief Editorial on Clinical Presentation and Treatment of Radiation Retinopathy Following Plaque Brachytherapy of Choroidal Melanoma

Treatment of choroidal melanoma with radiation plaque brachytherapy (Iodine, (I125) avoids enucleation, salvages the globe, preserves the vision, achieves better local tumor control and prevents metastasis [1,2]. However, it can lead to complications such as keratitis, iris neovascularisation, cataract, radiation optic neuropathy, retinopathy, maculopathy and vitreous hemorrhage. Radiation retinopathy (RR) is one of the expected, common complications following external beam radiation, plaque brachytherapy of choridal melanoma, retinoblastoma, choroidal metastasis and orbital tumors.1,2 The common risk factors in the development of RR are posterior choroidal melanoma nearer to the fovea (< 3 mm from fovea), large choroidal tumors (base > 10mm), tumors limited to the choroid with no anterior uveal involvement, high radiation dose, use of radioisotope Iridium (Ir192) over I125, co-existing diabetes mellitus, hypertension, and use of radiosensitisers (such as chemotherapy) [1-3]. The severity and incidence of radiation retinopathy depends on size and location of the tumor, type of radiation used, method of delivery, total radiation dose and the fractionation scale.