Radiation Retinopathy After Whole-Brain Radiotherapy in a Patient With Pineal Gland Tumor
Bibliographic record
Abstract
Purpose: To describe a case of radiation retinopathy following craniospinal radiation and provide an overview of studies on radiation retinopathy following whole-brain radiotherapy. Methods: A retrospective chart review was conducted to collect a single patient’s data on demographics, radiation therapy, ophthalmologic examination findings, treatment, and outcomes. For the systematic review, OVID Medline, Embase, and Cochrane CENTRAL were searched for studies reporting on radiation retinopathy following whole-brain radiotherapy. Results: A 24-year-old man with a history of craniospinal radiation presented with proliferative maculopathy. Initial visual acuity was 20/150 in the right eye and 20/40 in the left eye. The patient received monthly intravitreal injections of bevacizumab followed by panretinal laser photocoagulation in both eyes. Maculopathy improved following treatment. Nine articles comprising 13 cases of radiation retinopathy following whole-brain radiotherapy (25 affected eyes; mean ± SD age, 43.3 ± 10.8 years; 46.2% male) were identified by systematic review. None of the patients had diabetes. Radiotherapy was indicated for primary central nervous system lymphoma (6 cases), metastatic spread of breast cancer (4 cases) or lung cancer (2 cases), and acute lymphocytic lymphoma (1 case). The median radiation dose received was 40.7 Gy (range, 30–50). Ten patients had received prior or concurrent chemotherapy. Median time from radiotherapy to symptom onset was 20.5 months (range, 2–216). More than half of patients developed retinopathy bilaterally. Conclusions: To our knowledge, this is the first systematic review to highlight the risk of radiation retinopathy following whole-brain radiotherapy, particularly the increased frequency in patients who have received chemotherapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".