Delhi Journal of Ophthalmology

Ocular Complications of Radiotherapy For Head and Neck Tumours

Sarita Maharia, Kalpna Jain, H.S. Kumar
Department of Ophthalmology, S.P. Medical College, Bikaner, Rajasthan, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Kalpna Jain 
MS
Professor, Department of Ophthalmology
S.P. Medical College, Bikaner-334003,
Rajasthan, India
Email id: kalpnadaga@gmail.com


Published Online: 31-JAN-2019
DOI: https://dx.doi.org/10.7869/djo.418

Abstract
Aim: To study the various ocular complications associated with radiotherapy and correlate them with duration & dose of radiation.
Design: Hospital based prospective study
Methods: The present study comprises of 100 patients of head and neck tumors who received radiotherapy by linear accelerator from September 2015 to February 2017. Ocular examination was done prior to the start of therapy, 1st follow up at 15th day of therapy, 2nd at last day of therapy (23-35 fraction), 3rd at 3 month after completion of therapy for side effects, 4th at 6 month, 5th at 12 month and 6th at 18 months after completion of therapy for assessing chronic side effects.
Results: Astrocytoma was the most common tumour (35%). Maximum tumours of head and neck received 50-60 Gy of radiation. Nasopharyngeal carcinomas received maximum dose of radiation i.e. 60-70 Gy. Seventy one percent patients were male and 21% were female. Acute side effects were madarosis (19%), dermatitis (13%), conjunctivitis (3%), meibomitis (12%). Dry eye (33%) was seen in patients within hours to days after exposure to radiation or within 3 months of completion of therapy. Chronic side effects were dry eye (26%), punctal stenosis (1%), cataract (in 4 eyes), seen after 3 months or even a year after completion of therapy. Cataract occurred after > 20 Gy dose received by the lens. Radiation retinopathy and optic neuropathy were not seen till our last follow up.
Conclusion: The current study suggests the importance of total dose as well as dose per fraction despite advancement of radiotherapy techniques and using protective mechanisms for eye complications developed.

Keywords :Radiotherapy, Linear accelerator, Dry eye