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Radiation optic neuropathy after stereotactic radiosurgery
C A Girkin1, C H Comey, L D Lunsford
1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, USA.
Ophthalmology
|October 23, 1997
Summary
Optic neuropathy is a rare complication following stereotactic radiosurgery for perichiasmal tumors. Careful dose planning, limiting radiation to visual pathways, can reduce this risk.
Area of Science:
- Neurology
- Ophthalmology
- Radiation Oncology
Background:
- Stereotactic radiosurgery (SRS) is used for perichiasmal tumors.
- Visual pathway complications are a concern with SRS in this region.
Observation:
- Four patients developed optic neuropathy 7-30 months post-SRS.
- Sudden visual deterioration and anterior visual pathway involvement were noted.
- MRI revealed swelling and enhancement of visual pathways in three patients.
Findings:
- Visual field defects included nerve fiber bundle and homonymous hemianopic patterns.
- Corticosteroids offered partial recovery in one patient; hyperbaric oxygen was ineffective.
- Optic neuropathy is a rare but significant complication of SRS for perichiasmal tumors.
Implications:
- MRI-guided dose planning is crucial for SRS near visual pathways.
- Limiting maximal radiation dose to visual pathways below 8 Gy may prevent optic neuropathy.
- This highlights the importance of precise radiation delivery to minimize visual morbidity.