Abstract
Objective: Non-thyroidal complication of high-dose radioiodine therapy for thyroid carcinoma might cause salivary and lacrimal gland dysfunction, which may be transient or permanent in a dose-dependent manner. However, radiation retinopathy complicating 131I therapy, has not been previously well characterized. The aim of this study was to evaluate the extent of retinal damage among patients who had received high doses of radioiodine treatment.Methods: Forty eyes of 20 patients (3 male, 17 female) who received 250-1000 mCi during 131I therapy and on ophthalmological follow up for a year after the last treatment were included in the study. Mean age of the study group was 50 years (range 25-70 years). In ophthalmologic examination, visual acuity was measured in order to determine visual loss. Intraocular pressure was measured in all the patients. Then lens examination was carried out with slit lamp biomicroscopy in order to investigate cataract or partial lens opacities. Fundus observation was carried out through the dilated pupil with slit lamp biomicroscopy using 90 D noncontact lens.Result: The best corrected visual aquity with Snellen chart was found as 1.0 in 36 eyes (90%) and between 0.6 and 0.9 (10%) in 4 eyes (10%). At the biomicroscopic fundus examination, retinal hemorrhage consistent with radiation retinopathy, microaneurysm, microinfarction, edema or exudation, vitreus hemorrhage, partial or total optical disc pallor indicating papillopathy in the optic disc were not observed in any of the eyes.Conclusion: This result indicates that there is not any significant correlation between repeated high-dose radioiodine therapy and radiation retinopathy in differentiated thyroid carcinomas. Even though there is not a significant restriction in use of higher doses of radioiodine therapy in differentiated thyroid carcinoma, more extensive studies are needed in order to obtain more accurate data on possible occurrence of retinopathy.
Highlights
Radioiodine (Radioiodine (RI)) is used for the ablation of postoperative residual thyroid tissue in differential thyroid carcinomas [1]
It is generally seen after ionized radiation and 125I brachytherapy applied to the intraocular tumors, showing a slow progression and causing occlusion in retinal capillary, nonperfusion and large retinal vessels with neovascularization [6]
The best corrected visual aquity with Snellen chart was found as 1.0 in 36 eyes (90%) and between 0.6 and 0.9 (10%) in 4 eyes (10%) There was pseudophakic posterior capsule opacification in two eyes and nuclear cataract in two eyes which did not interfere with fundus examination
Summary
Radioiodine (Radioiodine (RI) (iodine-131, or 131I)) is used for the ablation of postoperative residual thyroid tissue in differential thyroid carcinomas [1]. Serious acute complications are extremely rare following radioiodine treatment, several side effects could occur [2,3,4]. Gastrointestinal complaints, salivary gland and lacrimal gland swelling with pain are mainly reported side effects, there are no large prospective series on the side effects of radioiodine therapy in the literature. The current literature on this subject is mainly consists of retrospective studies and case reports [5]. Radiation retinopathy is an occlusive vasculopathy which begins in the late period following radiotherapy. It is generally seen after ionized radiation and 125I brachytherapy applied to the intraocular tumors, showing a slow progression and causing occlusion in retinal capillary, nonperfusion and large retinal vessels with neovascularization [6]
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