Kinyoun J L, Kalina R E, Brower S A, Mills R P, Johnson R H
Arch Ophthalmol. 1984 Oct;102(10):1473-6. doi: 10.1001/archopht.1984.01040031193016.
Recent reports indicate that orbital irradiation for Graves' ophthalmopathy is sometimes beneficial, particularly for dysthyroid optic neuropathy, and is not associated with serious complications. We are aware, however, of four patients who were found to have radiation retinopathy after orbital irradiation for Grave's ophthalmopathy. All four patients have decreased central acuity, and three of the four are legally blind in one or both eyes. Computer reconstruction of the dosimetry, based on computed tomography and beam profiles, shows that errors in dosage calculations and radiotherapy technique probably account for the radiation retinopathy in three of the four patients. Radiotherapy for Graves' ophthalmopathy should be administered only by competent radiotherapists who are experienced in the treatment of this disease. Similar errors in dosage calculations and treatment techniques may account for other reports of radiation retinopathy after reportedly safe dosages.
近期报告表明，对格雷夫斯眼病进行眼眶照射有时是有益的，特别是对于甲状腺功能障碍性视神经病变，且不会引发严重并发症。然而，我们了解到有4例患者在接受格雷夫斯眼病眼眶照射后出现了放射性视网膜病变。这4例患者的中心视力均下降，其中3例单眼或双眼法定失明。基于计算机断层扫描和射束轮廓进行的剂量测定计算机重建显示，剂量计算和放疗技术失误可能是4例患者中3例发生放射性视网膜病变的原因。格雷夫斯眼病的放疗应由有能力且有该病治疗经验的放射治疗师进行。剂量计算和治疗技术方面的类似失误可能是其他关于在据报道为安全剂量后出现放射性视网膜病变报告的原因。
