We report the observation of a 31-year-old patient followed for nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 70 Grays. She presented with a progressive decline in bilateral visual acuity. Ophthalmologic examination reveals bilateral posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The optical coherence tomography OCT B-scan showed more pronounced macular edema in the right eye. The OCTA reveals enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti VEGF, without improvement in visual acuity.
The aim of this case report is to study, the contribution of optical coherence tomography angiography (OCTA) in the diagnosis of radiation maculopathy, and attribute these changes to ischemia at the level of the retinal vascular network.