Bilateral Radiation Optic Neuropathy Following Concurrent Chemotherapy and Radiation in Glioblastoma

Abstract

Radiation optic neuropathy (RON) is an iatrogenic complication that causes severe, irreversible vision loss within months to years following radiation to lesions close to the visual pathway. The authors describe a case of RON in glioblastoma after radio-sensitisation with temozolomide with sequential involvement of both optic nerves. This case provides a timeline for clinical and imaging findings with RON and specifically resolution of nerve enhancement. The authors also highlight the potential of an increase in incidence of RON in glioblastoma with advances in survival seen with greater use of second-line chemotherapy and even re-radiation.

Variable cardiovascular risk factors is a risk factor for overall survival of patients with esophageal squamous cell carcinoma after surgery: a retrospective cohort study

“…Radiation heart disease is a potential sequela of radiotherapy. Early manifestations of radiation heart disease include pericardial effusion and pericardial in ammation, and advanced manifestations include restrictive heart disease, arrhythmias and heart failure [22,23]. The esophagus is close to the heart, so the heart is at risk of radiation exposure during radiation therapy for esophageal cancer.…”

Effects and Assessment of the Optic Pathway After Management with Stereotactic Radiosurgery for Intracranial Tumors: A Comprehensive Literature Review

“…Infiltrative, paraneoplastic, and compression optic neuropathies usually present bilaterally but asymmetrically. The only pathology in the differential diagnosis generally unilateral during the disease is anterior radiation-induced optic neuropathy (A-RION) in the context of giant cell arteritis (GCA) [ 33 ]. The fundus in the earliest stages of posterior radiation-induced optic neuropathy (P-RION) is usually completely normal.…”

“…It is until the sixth to eighth week that the edematous and atrophic optic disc and fundus pallor begin to be noticed [ 31 , 34 ]. In arteritic and non-arteritic AION, infiltrative optic neuropathies, and paraneoplastic syndromes, the fundus frequently changes from the beginning, presenting edema, microhemorrhages, and cotton-wool spots [ 33 ].…”