Last additions - Radiation Retinopathy and Macular Pucker 4 Years Post Melanoma Brachytherapy 67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye in 2006. She had cataract surgery February of 2009 and a posterior sub-Tenon Kenalog injection in April. Her vision in the left eye is hazy and she has trouble seeing out of it.
VISUAL ACUITY: OS 20/70. IOP: 11. The posterior chamber intraocular lens is in good position.
EXTENDED OPHTHALMOSCOPY:
OS: Vertical C/D ratio is 0.3. There are 2+ vitreous cells. There is a 3+ epiretinal membrane. There is radiation and retinopathy nasal to the optic nerve and there is a melanoma, which has regressed superonasally.
OCT SCAN: The OCT scan shows an average central foveal thickness of 347 microns, which is stable. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows some irregularities where the macular pucker is and the radiation retinopathy is nasally away from the optic nerve with the capillary closure over the tumor.
IMPRESSION:
1. STATUS POST RADIATION FOR MELANOMA – LEFT EYE
2. MACULAR PUCKER – LEFT EYE
DISCUSSION: I explained to the patient with 20/70 vision with the macular pucker, she is a reasonable candidate for macular pucker surgery. She would like to try that if it would improve her vision. I told her there is an 80 percent chance of her vision improving about half way to normal with the therapy.
(Vision improved to 20/40 6 months after vitrectomy for pucker)
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma510 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma411 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma503 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma463 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma476 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma432 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma461 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma357 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma456 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma488 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma508 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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Radiation Retinopathy and Macular Pucker 4 years following Brachytherapy (Plaque) for Nasal Melanoma700 views67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye 4 years aog. She had cataract surgery 2 years ago and a posterior sub-Tenon Kenalog injection in 7 months ago. Her vision in the left eye is hazy and she has trouble seeing out of it. VA OS 20/70. Sep 20, 2011
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67-year-old woman has a macular pucker in the left eye. She had radiation for a melanoma in that eye in 2006. She had cataract surgery February of 2009 and a posterior sub-Tenon Kenalog injection in April. Her vision in the left eye is hazy and she has trouble seeing out of it.
VISUAL ACUITY: OS 20/70. IOP: 11. The posterior chamber intraocular lens is in good position.
EXTENDED OPHTHALMOSCOPY:
OS: Vertical C/D ratio is 0.3. There are 2+ vitreous cells. There is a 3+ epiretinal membrane. There is radiation and retinopathy nasal to the optic nerve and there is a melanoma, which has regressed superonasally.
OCT SCAN: The OCT scan shows an average central foveal thickness of 347 microns, which is stable. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows some irregularities where the macular pucker is and the radiation retinopathy is nasally away from the optic nerve with the capillary closure over the tumor.
IMPRESSION:
1. STATUS POST RADIATION FOR MELANOMA – LEFT EYE
2. MACULAR PUCKER – LEFT EYE
DISCUSSION: I explained to the patient with 20/70 vision with the macular pucker, she is a reasonable candidate for macular pucker surgery. She would like to try that if it would improve her vision. I told her there is an 80 percent chance of her vision improving about half way to normal with the therapy.
(Vision improved to 20/40 6 months after vitrectomy for pucker)
