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Radiation optic neuropathy and retinopathy in patients with presumed benign intraorbital tumours treated with fractionated stereotactic radiotherapy

Eye volume 37, pages 2470–2474 (2023)Cite this article

Subjects

Abstract

Purpose

To assess the long-term effects of fractionated stereotactic radiotherapy (fSRT) for the treatment of (presumed) benign intraorbital tumours on visual acuity, visual fields, globe and eyelid position, and complications including radiation retinopathy and deviations of retinal nerve fibre layer (RNFL) on OCT.

Methods

Multi-centre retrospective follow-up study of a consecutive series of 25 patients treated in the Rotterdam Orbital Center (collaboration between Erasmus Medical Center and Rotterdam Eye Hospital) between 2002 and 2018. Data on the dose of fSRT, visual acuity, Humphrey field analyser (HFA) perimetry, globe and eyelid position were obtained from the medical records.

Results

In this retrospective consecutive series of 25 patients with a median follow-up of 104 months (range 48–215 months), 80.0% of the patients had presumed optic nerve sheath meningioma and 20.0 % presumed cavernous haemangioma with signs suggestive of recent growth. In most patients, a better visual acuity and RNFL thickness were observed after stereotactic radiotherapy. Improvement of the visual field defects was observed after treatment, with a mean deviation of −14.98 dB (12.9 SD) before treatment versus −4.56 dB (10.8 SD) after treatment, respectively. Significant, but small changes in exophthalmometry values were observed with a mean of 14.92 mm (7.9 SD) versus 13.79 mm (7.3 SD) after treatment, respectively. Only 3 patients (15.0%) developed radiation retinopathy after stereotactic radiotherapy. All patients with radiation retinopathy had presumed optic nerve sheath meningioma.

Conclusions

Based on our results, fSRT is an effective treatment modality for this subset of orbital tumours with few complications and good long-term visual and cosmetic outcomes. FSRT is non-invasive and safer than surgery for lesions in the posterior orbit or around the optic nerve.

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Fig. 1: The mean best corrected visual acuity and the mean deviation in visual fields at each follow-up visit.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Rotterdam Eye Hospital, Rotterdam, The Netherlands

    O. Gishti, R. O. B. de Keizer, S. E. Detiger & D. Paridaens

  2. Department of Ophthalmology, Anna Hospital, Geldrop, The Netherlands

    O. Gishti

  3. Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands

    C. van Rij & C. Slagter

  4. Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    D. Paridaens

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  1. O. Gishti
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  2. R. O. B. de Keizer
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  3. S. E. Detiger
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  4. C. van Rij
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  5. C. Slagter
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  6. D. Paridaens
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Contributions

OG and DP designed the study. OG and ROBK performed the analyses. OG and SED wrote the manuscript. ROBK, SED, CvR, CS and DP advised and reviewed the manuscript. All authors confirm that neither this manuscript nor any part of it has been published and is not under consideration for publication elsewhere.

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Correspondence to O. Gishti.

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Gishti, O., de Keizer, R.O.B., Detiger, S.E. et al. Radiation optic neuropathy and retinopathy in patients with presumed benign intraorbital tumours treated with fractionated stereotactic radiotherapy. Eye 37, 2470–2474 (2023). https://doi.org/10.1038/s41433-022-02356-0

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