Purpose This study aimed to evaluate the radiation-induced adverse effects on ocular structures in head and neck cancer patients and investigate the radiation dose-volume effects on the cornea, lacrimal gland, retina, optic nerve and chiasm.
Materials and Methods A total of 38 eyes of 19 patients were included in this prospective, cohort study. All patients underwent complete ophthalmological examination in addition to contrast sensitivity, visual field and visual evoked potentials (VEP) tests. Ophthalmological examinations and psychophysical tests were performed in 6th, 12th, 18th, 24th months and in the last visit. The relationship between the ophthalmologic findings, and the radiation doses below and above the cut-off values was evaluated.
Results Contrast sensitivity decrease and visual field deterioration were observed in 42% of the patients in the last visit (median 26 months) whereas a prolonged latency and decreased amplitude of P100 wave in VEP was observed in 58% and 33% of the eyes, respectively at 24th month. Totally 16 patients (84.2%) developed dry eye disease and eight of them received radiotherapy below tolerance doses and had mild to moderate dry eye findings. Radiation-induced retinopathy was observed in three of the eyes in eight patients who received radiation above tolerance dose.
Conclusion Head and neck cancers treated with radiotherapy, resulted in various ophthalmic complications. All patients who are treating with radiotherapy should be evaluated by an ophthalmologist in terms of anterior and posterior segment damage, even if the radiation dose is below the tolerance limit.
Citations
Citations to this article as recorded by
A deep dive into radiation keratopathy; Going beyond the current frontierss Mohammad Soleimani, Seyed Mahbod Baharnoori, Hamed Massoumi, Kasra Cheraqpour, Hassan Asadigandomani, Arash Mirzaei, Mohammad Javad Ashraf, Raghuram Koganti, Madhurima Chaudhuri, Mahmood Ghassemi, Elmira Jalilian, Ali R. Djalilian Experimental Eye Research.2025; 251: 110234. CrossRef
Monte Carlo simulation of polymer phantoms in proton therapy for eye tumor treatment Engin Aşlar, Fatih Ekinci The European Physical Journal Plus.2025;[Epub] CrossRef
Potential Risks of Ocular Molecular and Cellular Changes in Spaceflight Ryung Lee, Joshua Ong, Ethan Waisberg, Thomas Mader, John Berdahl, Alex Suh, Nicholas Panzo, Hamza Memon, Ritu Sampige, Blake Katsev, Cihan Mehmet Kadipasaoglu, Christopher E. Mason, Afshin Beheshti, Sara R. Zwart, Scott M. Smith, Andrew G. Lee Seminars in Ophthalmology.2025; 40(8): 756. CrossRef
Spaceflight associated dry eye syndrome (SADES): Outflow biophysics and infection risk Ryung Lee, Joshua Ong, Ethan Waisberg, Stacey L. Fanning, Andrew G. Lee Journal of Space Safety Engineering.2025; 12(2): 377. CrossRef
Radiotherapy for Orbital Myeloid Sarcoma as Extramedullary Relapse in a Pediatric Acute Myeloid Leukemia Patient Post-haploidentical Bone Marrow Transplantation Mohammadhossein Ghafouri, Ramesh Boggula, Christopher Nagle, Michael C Joiner, Steven R Miller Cureus.2025;[Epub] CrossRef
The Effects of Radiation Therapy on the Ocular Apparatus: Implications for Management Frank J. Arturi, Danielle Arons, Nicholas J. Murphy, Catherine Yu, Drishti Panse, Daniel R. Cherry, Kristin Hsieh, Julie R. Bloom, Anthony D. Nehlsen, Lucas Resende Salgado, Kunal K. Sindhu Cancers.2025; 17(16): 2605. CrossRef
Risk Factors for Radiation-Induced Keratoconjunctivitis Sicca in Dogs Treated with Hypofractionated Intensity-Modulated Radiation Therapy for Intranasal Tumors Akihiro Ohnishi, Soichirou Takeda, Yoshiki Okada, Manami Tokoro, Saki Kageyama, Yoshiki Itoh, Taketoshi Asanuma Animals.2025; 15(15): 2258. CrossRef
Evaluation of acute ocular toxicity after definitive-intent radiation therapy in canine sinonasal tumors Jonas Brückner, Carla Rohrer Bley, Antonella Rampazzo, Sergejs Unterkirhers, Simon Pot, Valeria Meier, Douglas H. Thamm PLOS One.2025; 20(8): e0329073. CrossRef
Association between dry mouth and dry eyes: a systematic literature review of clinical evidence Wiktoria Potocka, Zainab Assy, Mirjam M. A. van Tilborg, Floris J. Bikker, Marja L. Laine Rheumatology International.2025;[Epub] CrossRef
Prognostic models for radiation-induced complications after radiotherapy in head and neck cancer patients Toshihiko Takada, Makbule Tambas, Enrico Clementel, Artuur Leeuwenberg, Marjan Sharabiani, Johanna AAG Damen, Zoë S Dunias, Jan F Nauta, Demy L Idema, Jungyeon Choi, Lotta M Meijerink, Johannes A Langendijk, Karel GM Moons, Ewoud Schuit Cochrane Database of Systematic Reviews.2025;[Epub] CrossRef
Management of late toxicities and specific follow-up needs of adolescent and young adult cancer survivors: recommendations from scientific societies in Spain Alejandro Pérez Fidalgo, Pilar Alonso, Maitane Andión, Adela Cañete, Erica Collado, Carmen Garrido Colino, José Gómez Codina, Xavier Díaz Carrasco, Ramón García Sanz, Sergio Hernández Expósito, Teresa Lopez-Fernandez, Gabriela Medin, Antonio Molinés, Albe Clinical and Translational Oncology.2025;[Epub] CrossRef
A Case of External Beam Radiation Therapy (EBRT) Induced Corneal Damage in the Treatment of Squamoid Eccrine Ductal Carcinoma (SEDC). Amelia Momtazzadeh, Ilakiya Raghavendiran, Christina Henson, Annie Moreau, Elise E. Steinberger Advances in Radiation Oncology.2025; : 101935. CrossRef
Radiation Therapy Complications in Choroidal Melanoma and Strategies for Their Management E. M. Svistunova, I. A. Al-Mousa, L. A. Insarkina, A. A. Bykhovsky, I. E. Panova Ural Medical Journal.2025; 24(5): 64. CrossRef
Neurological complications of modern radiotherapy for head and neck cancer James C.H. Chow, Jason C.S. Ho, Ka Man Cheung, David Johnson, Bonaventure Y.M. Ip, Jonathan J. Beitler, Primož Strojan, Antti A. Mäkitie, Avraham Eisbruch, Sweet Ping Ng, Sandra Nuyts, William M. Mendenhall, Silvia Babighian, Alfio Ferlito Radiotherapy and Oncology.2024; 194: 110200. CrossRef
Efficacy of Intravitreal Injections Anti-Vascular Endothelial Growth Factor Treatment for Radiation Retinopathy: A Systematic Review and Meta-analysis Jiayuan Zhuang, Yang Yang, Yuexia Liao, Chenghao Li, Wen-an Wang, Xiangxia Luo, Heng Zhou American Journal of Ophthalmology.2024; 263: 141. CrossRef
Personalized treatment for patients with lacrimal sac squamous cell carcinoma Jie Wang, Qi Zhang, Xiuqian Yi, Tianci Tang, Tian Wang, Xinmao Song Canadian Journal of Ophthalmology.2024; 59(6): e768. CrossRef
Biomaterials-mediated radiation-induced diseases treatment and radiation protection Jianping Man, Yanhua Shen, Yujie Song, Kai Yang, Pei Pei, Lin Hu Journal of Controlled Release.2024; 370: 318. CrossRef
Retinopatía por radiación vs. síndrome isquémico ocular: ¿cómo llegar al diagnóstico? A. Aramburu-González, J. Zarrabeitia Carrandi, C.B. Robles Elejalde, A. Quilez Larragan Archivos de la Sociedad Española de Oftalmología.2024; 99(8): 352. CrossRef
Orbital cavernous venous malformation shrinkage during fractionated stereotactic radiotherapy contributing to the development of radiation retinopathy Laura Hughes, Amy C Cohn, Neda Haghighi, Alan A McNab European Journal of Ophthalmology.2024; 34(5): NP53. CrossRef
Radiation retinopathy vs. ocular ischemic syndrome: how to reach the diagnosis? A. Aramburu-González, J. Zarrabeitia Carrandi, C.B. Robles Elejalde, A. Quilez Larragan Archivos de la Sociedad Española de Oftalmología (English Edition).2024; 99(8): 352. CrossRef
Ocular surface changes in patients who have undergone head and neck radiation therapy H Sujithra, Kannisha N Shah, R Anoop, Pushpaja K Ullattil, Gopal S Pillai, Greeshma C Ravindran, Jayesh Vazirani Indian Journal of Ophthalmology.2024;[Epub] CrossRef
New Frontiers in the Treatment of Patients with HER2+ Cancer and Brain Metastases: Is Radiotherapy Always Useful? Giuseppa Scandurra, Valentina Lombardo, Giuseppe Scibilia, Daniela Sambataro, Vittorio Gebbia, Paolo Scollo, Basilio Pecorino, Maria Rosaria Valerio Cancers.2024; 16(13): 2466. CrossRef
Radiation-Induced Retinopathy and Optic Neuropathy after Radiation Therapy for Brain, Head, and Neck Tumors: A Systematic Review Buket Kinaci-Tas, Tanja Alderliesten, Frank D. Verbraak, Coen R. N. Rasch Cancers.2023; 15(7): 1999. CrossRef
Radiation Retinopathy Kaylie Chen, Andrew W. Browne Current Ophthalmology Reports.2023; 11(3): 49. CrossRef
Efficacy and Safety of Radiotherapy Combined with Pyrotinib in the Treatment of HER2-Positive Breast Cancer with Brain Metastases Jie Huang, Wenqiang Zhu, Qiangzhi Duan, Chaomang Zhu, Xueling Shi, Hongyu Zhao, Peng Cai, Duojie Li Breast Cancer: Targets and Therapy.2023; Volume 15: 841. CrossRef
Comparable meibomian gland changes in patients with and without ocular graft-versus-host disease after hematopoietic stem cell transplantation Wenxin Zhao, Jing Yang, Yinglin Liao, Hubert Yuenhei Lao, Quanbin Huang, Ling Jin, Jing Sun, Fen Huang, Lingyi Liang The Ocular Surface.2022; 25: 1. CrossRef