Catastrophic vision loss from radiation-induced optic neuropathy

Area of Science:

• Neuro-oncology
• Ophthalmology
• Radiation Oncology

Background:

• Craniopharyngioma treatment often involves radiation therapy, which can cause significant side effects.
• Radiation-induced optic neuropathy is a known complication, but its management remains challenging.

Observation:

• A 68-year-old woman developed progressive vision loss following craniopharyngioma resection and radiation.
• Ophthalmological examination revealed profound vision loss and bilateral optic disc pallor.
• Brain MRI demonstrated reduced sellar mass but showed pre-chiasmatic enhancement of optic nerves.

Findings:

• The patient was diagnosed with radiation-induced optic neuropathy.
• Despite treatment with high-dose corticosteroids, hyperbaric oxygen, and bevacizumab, vision loss progressed to no light perception in both eyes.

Implications:

• This case highlights the severe and often irreversible vision loss associated with radiation-induced optic neuropathy.
• It underscores the need for careful monitoring and potentially novel therapeutic strategies for managing this complication.
• Further research into neuroprotective agents and alternative treatment modalities is warranted.