Radiation Retinopathy with OCT

This montage of color fundus photographs comes from an 81-year-old male patient with radiation retinopathy following I125 brachytherapy. This patient has macular edema (best seen in the OCT, purple arrow) which is common at 12-18 months following brachytherapy. The pallor of the optic disc reflects radiation optic neuropathy (green arrow). The regressed melanoma appears as the slate gray area (red arrow). There is atrophy of the choroid as a result of the intense radiation inferior to the melanoma (yellow arrow). Lipid is also present reflecting leaky retinal vessels (turquoise arrow). Radiation retinopathy is a bigger visual problem the closer the tumor is to the macula.