Radiation maculopathy after proton beam irradiation for choroidal melanoma

Ophthalmology. 1992 Aug;99(8):1278-85. doi: 10.1016/s0161-6420(92)31832-9.


Purpose: Radiation maculopathy is a microangiopathy of the retina, which is often observed after irradiation of the eye. To quantitatively determine the frequency of anatomic and functional features of this condition, the authors reviewed a large series of patients with choroidal melanomas who were treated by proton beam irradiation.

Methods: Color photographs and/or fluorescein angiograms of 218 patients with paramacular choroidal melanomas were graded by two independent masked readers to determine the frequency of the various lesions of radiation maculopathy.

Results: Overall, 194 (89%) of the 218 patients in this study developed some degree of radiation maculopathy. The earliest and most common finding was macular edema, which was observed in 87% of patients, overall, by the end of year 3. Microvascular changes (microaneurysms and/or telangiectasia), intraretinal hemorrhages, and capillary nonperfusion were noted in 76%, 70%, and 64% of eyes, respectively, by the end of postirradiation year 3. Visual acuity was retained at 20/200 or better in 90% of eyes 1 year after irradiation and in 67% of eyes 3 years after treatment.

Conclusion: Radiation maculopathy is common after proton beam irradiation of paramacular choroidal melanomas. However, ambulatory vision is preserved in many eyes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Choroid Neoplasms / radiotherapy*
  • Female
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Macula Lutea / radiation effects*
  • Male
  • Melanoma / radiotherapy*
  • Middle Aged
  • Photography
  • Protons
  • Radiation Injuries / etiology*
  • Retinal Diseases / etiology*
  • Retinal Vessels / radiation effects
  • Visual Acuity / radiation effects


  • Protons