Progress in clinical prevention and treatment of radiation-induced optic neuropathy and reflections_Chinese Journal of Ocular Fundus Diseases

Authors：

Fu Tao ¹ ,  Wei Shihui ²

1. Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;
2. Senior Department of Ophthalmology, The Chinese PLA General Hospital, Beijing 100853, China;

Corresponding?author：

Wei Shihui, Email: weishihui706@hotmail.com

Keywords：

Radiation-induced optic neuropathy; Head and neck tumor; Radiation therapy; Editorial

DOI：

10.3760/cma.j.cn511434-20260306-00108

Video：

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Abstract Full text Figures/Tables Video References Cited by

Radiation-induced optic neuropathy (RION) is a severe complication of radiotherapy for head and neck tumors, characterized by painless, often irreversible visual decline after a long and highly variable latent period. Its incidence correlates with radiotherapy techniques and tumor types, with radiation dose constituting the principal risk factor. Advanced age and pre-existing vascular conditions can further elevate the risk of RION. The underlying pathology is thought to involve vascular injury, dysregulated molecular signaling, and impaired axoplasmic transport, although these mechanisms are not fully understood. Diagnosis in clinical practice remains largely exclusionary, based on patient history, imaging, and visual function testing. No specific cure exists, so management focuses on symptomatic relief and vision stabilization. Adherence to established safe radiation dose thresholds is the most effective strategy for reducing RION incidence. This review synthesizes clinical insights to summarize the epidemiology, risk factors, pathophysiology, diagnosis, and management of RION, discusses ongoing challenges in its prevention and treatment, and aims to inform more precise prevention and personalized therapeutic strategies.

Citation： Fu Tao, Wei Shihui. Progress in clinical prevention and treatment of radiation-induced optic neuropathy and reflections. Chinese Journal of Ocular Fundus Diseases, 2026, 42(4): 277-283. doi: 10.3760/cma.j.cn511434-20260306-00108 Copy

1.	Leber KA, Bergl?ff J, Pendl G. Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery[J]. J Neurosurg, 1998, 88(1): 43-50. DOI: 10.3171/jns.1998.88.1.0043.
2.	Ataídes FG, Silva SFBR, Baldin JJCMC. Radiation-induced optic neuropathy: literature review[J]. Neuro-Ophthalmology, 2020, 45(3): 172-180. DOI: 10.1080/01658107.2020.1817946.
3.	Carey AR, Page BR, Miller N. Radiation-induced optic neuropathy: a review[J]. Br J Ophthalmol, 2023, 107(6): 743-749. DOI: 10.1136/bjo-2022-322854.
4.	張燕, 李紅陽, 彭春霞, 等. 放射性視神經病變的診療特征[J]. 國際眼科雜志, 2014, 14(6): 1095-1099. DOI: 10.3980/j.issn.1672-5123.2014.06.31.Zhang Y, Li HY, Peng CX, et al. Diagnosis and treatment characteristics of radioactive optic neuropathy[J]. Int Eye Sci, 2014, 14(6): 1095-1099. DOI: 10.3980/j.issn.1672-5123.2014.06.31.
5.	Hall WA, Das JM. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT)[M/OL]. StatPearls. Treasure Island (FL): StatPearls Publishing, 2025. https://www.ncbi.nlm.nih.gov/sites/books/NBK542166/.
6.	Seung SK, Larson DA, Galvin JM, et al. American college of radiology (ACR) and American society for radiation oncology (ASTRO) practice guideline for the performance of stereotactic radiosurgery (SRS)[J]. Am J Clin Oncol, 2013, 36(3): 310-315. DOI: 10.1097/COC.0b013e31826e053d.
7.	Kinaci-Tas B, Alderliesten T, Verbraak FD, et al. Radiation-induced retinopathy and optic neuropathy after radiation therapy for brain, head, and neck tumors: a systematic review[J/OL]. Cancers, 2023, 15(7): 1999[2023-03-27]. https://pubmed.ncbi.nlm.nih.gov/37046660/. DOI: 10.3390/cancers15071999.
8.	Peters DR, Asher A, Conti A, et al. Single fraction and hypofractionated radiosurgery for perioptic meningiomas—tumor control and visual outcomes: a systematic review and meta-analysis[J/OL]. Neurosurg Rev, 2023, 46(1): 287[2023-10-28]. https://pubmed.ncbi.nlm.nih.gov/37897519/. DOI: 10.1007/s10143-023-02197-9.
9.	Asuzu DT, Bunevicius A, Kormath Anand R, et al. Clinical and radiologic outcomes after stereotactic radiosurgery for meningiomas in direct contact with the optic apparatus: an international multicenter study[J]. J Neurosurg, 2021, 136(4): 1070-1076. DOI: 10.3171/2021.3.JNS21328.
10.	Hasegawa T, Kobayashi T, Kida Y. Tolerance of the optic apparatus in single-fraction irradiation using stereotactic radiosurgery[J]. Neurosurgery, 2010, 66(4): 688-695. DOI: 10.1227/01.NEU.0000367554.96981.26.
11.	Paek SH, Downes MB, Bednarz G, et al. Integration of surgery with fractionated stereotactic radiotherapy for treatment of nonfunctioning pituitary macroadenomas[J]. Int J Radiat Oncol Biol Phys, 2005, 61(3): 795-808. DOI: 10.1016/j.ijrobp.2004.07.688.
12.	Deng MY, Rauh S, Anil G, et al. Analysis of safety and efficacy of proton radiotherapy for optic nerve sheath meningioma[J/OL]. Neurooncol Adv, 2024, 6(1): vdae160[2024-09-21]. https://pubmed.ncbi.nlm.nih.gov/39434923/. DOI: 10.1093/noajnl/vdae160.
13.	K?the A, Feuvret L, Weber DC, et al. Assessment of radiation-induced optic neuropathy in a multi-institutional cohort of chordoma and chondrosarcoma patients treated with proton therapy[J/OL]. Cancers, 2021, 13(21): 5327[2021-10-23]. https://pubmed.ncbi.nlm.nih.gov/34771490/. DOI: 10.3390/cancers13215327.
14.	Astradsson A, Wiencke AK, Munck af Rosenschold P, et al. Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors[J]. J Neurooncol, 2014, 118(1): 101-108. DOI: 10.1007/s11060-014-1399-0.
15.	Chen HY, Chuang CC, Chen HC, et al. Clinical outcomes of fractionated stereotactic radiosurgery in treating perioptic meningiomas and schwannomas: a single-institutional experience[J]. J Clin Neurosci, 2020, 81: 409-415. DOI: 10.1016/j.jocn.2020.09.058.
16.	Farzin M, Molls M, Kampfer S, et al. Optic toxicity in radiation treatment of meningioma: a retrospective study in 213 patients[J]. J Neurooncol, 2016, 127(3): 597-606. DOI: 10.1007/s11060-016-2071-7.
17.	Wu YL, Li WF, Yang KB, et al. Long-term evaluation and normal tissue complication probability (NTCP) models for predicting radiation-induced optic neuropathy after intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma: a large retrospective study in China[J/OL]. J Oncol, 2022, 2022: 3647462[2022-02-23]. https://pubmed.ncbi.nlm.nih.gov/35251172/. DOI: 10.1155/2022/3647462.
18.	Piquemal R, Cottier JP, Arsène S, et al. Radiation-induced optic neuropathy 4 years after radiation: report of a case followed up with MRI[J]. Neuroradiology, 1998, 40(7): 439-441. DOI: 10.1007/s002340050619.
19.	Wang Y, Fu J, Zhou H, et al. Clinical characteristics of radiation-induced optic neuropathy: a single-center retrospective study[J]. Adv Ophthalmol Pract Res, 2023, 3(3): 141-146. DOI: 10.1016/j.aopr.2023.05.003.
20.	Milano MT, Grimm J, Soltys SG, et al. Single-and multi-fraction stereotactic radiosurgery dose tolerances of the optic pathways[J]. Int J Radiat Oncol Biol Phys, 2021, 110(1): 87-99. DOI: 10.1016/j.ijrobp.2018.01.053.
21.	Kim JO, Ma R, Akagami R, et al. Long-term outcomes of fractionated stereotactic radiation therapy for pituitary adenomas at the BC cancer agency[J]. Int J Radiat Oncol Biol Phys, 2013, 87(3): 528-533. DOI: 10.1016/j.ijrobp.2013.06.2057.
22.	Fuji H, Nakasu Y, Ishida Y, et al. Feasibility of proton beam therapy for chordoma and chondrosarcoma of the skull base[J]. Skull Base, 2011, 21(3): 201-206. DOI: 10.1055/s-0031-1275636.
23.	Brecht S, Boda-Heggemann J, Budjan J, et al. Radiation-induced optic neuropathy after stereotactic and image guided intensity-modulated radiation therapy (IMRT)[J]. Radiother Oncol, 2019, 134: 166-177. DOI: 10.1016/j.radonc.2019.02.003.
24.	Kountouri M, Pica A, Walser M, et al. Radiation-induced optic neuropathy after pencil beam scanning proton therapy for skull-base and head and neck tumours[J/OL]. Br J Radiol, 2020, 93(1107): 20190028[2019-08-01]. https://pubmed.ncbi.nlm.nih.gov/31322969/. DOI: 10.1259/bjr.20190028.
25.	Demizu Y, Murakami M, Miyawaki D, et al. Analysis of vision loss caused by radiation-induced optic neuropathy after particle therapy for head-and-neck and skull-base tumors adjacent to optic nerves[J]. Int J Radiat Oncol Biol Phys, 2009, 75(5): 1487-1492. DOI: 10.1016/j.ijrobp.2008.12.068.
26.	Doroslova?ki P, Tamhankar MA, Liu GT, et al. Factors sssociated with occurrence of radiation-induced optic neuropathy at “safe” radiation dosage[J]. Semin Ophthalmol, 2018, 33(4): 581-588. DOI: 10.1080/08820538.2017.1346133.
27.	Lecornu M, Lesueur P, Salleron J, et al. Prospective assessment of early proton therapy-induced optic neuropathy in patients with intracranial, orbital or sinonasal tumors: impact of a standardized ophthalmological follow up[J/OL]. Front Oncol, 2021, 11: 673886[2021-06-15]. https://pubmed.ncbi.nlm.nih.gov/34211847/. DOI: 10.3389/fonc.2021.673886.
28.	Xiang M, Chan C, Wang L, et al. Physiological motion of the optic chiasm and its impact on stereotactic radiosurgery dose[J/OL]. Br J Radiol, 2019, 92(1099): 20190170[2019-05-22]. https://pubmed.ncbi.nlm.nih.gov/31067077/. DOI: 10.1259/bjr.20190170.
29.	Qing K, Nie K, Liu B, et al. The impact of optic nerve movement on intracranial radiation treatment[J/OL]. Front Oncol, 2022, 12: 803329[2022-02-24]. https://pubmed.ncbi.nlm.nih.gov/35280734/. DOI: 10.3389/fonc.2022.803329.
30.	Ferguson I, Huecker J, Huang J, et al. Risk factors for radiation-induced optic neuropathy: a case-control study[J]. Clin Exp Ophthalmol, 2017, 45(6): 592-597. DOI: 10.1111/ceo.12927.
31.	Young WC, Thornton AF, Gebarski SS, et al. Radiation-induced optic neuropathy: correlation of MR imaging and radiation dosimetry[J]. Radiology, 1992, 185(3): 904-907. DOI: 10.1148/radiology.185.3.1438784.
32.	Oakey Z, Ye?ilta? YS, Singh AD. Radiation optic neuropathy: management options[J]. Ocul Oncol Pathol, 2023, 9(5-6): 166-171. DOI: 10.1159/000533426.
33.	Rong R, Xia X, Peng H, et al. Cdk5-mediated Drp1 phosphorylation drives mitochondrial defects and neuronal apoptosis in radiation-induced optic neuropathy[J/OL]. Cell Death Dis, 2020, 11(9): 720[2020-09-03]. https://pubmed.ncbi.nlm.nih.gov/32883957/. DOI: 10.1038/s41419-020-02922-y.
34.	Yang J, Li Q, Han D, et al. Radiation-induced impairment of optic nerve axonal transport in tree shrews and rats monitored by longitudinal manganese-enhanced MRI[J]. Neurotoxicology, 2020, 77: 145-154. DOI: 10.1016/j.neuro.2020.01.008.
35.	Archer EL, Liao EA, Trobe JD. Radiation-induced optic neuropathy: clinical and imaging profile of twelve patients[J]. J Neuroophthalmol, 2019, 39(2): 170-180. DOI: 10.1097/WNO.0000000000000670.
36.	Pham TN, Mathis T, Azemar N, et al. Connecting visual perception with proton therapy-induced optic damage using archetypal analysis[J/OL]. Int J Part Ther, 2025, 18: 101211[2025-11-06]. https://pubmed.ncbi.nlm.nih.gov/41459013/. DOI: 10.1016/j.ijpt.2025.101211.
37.	Koné AS, Diakité AS, Ahid IM, et al. LENT SOMA tables[J]. Radiother Oncol, 1995, 35(1): 17-60.
38.	Baroni LV, Alderete D, Solano-Paez P, et al. Bevacizumab for pediatric radiation necrosis[J]. Neurooncol Pract, 2020, 7(4): 409-414. DOI: 10.1093/nop/npz072.
39.	Brown GC, Shields JA, Sanborn G, et al. Radiation optic neuropathy[J]. Ophthalmology, 1982, 89(12): 1489-1493. DOI: 10.1016/s0161-6420(82)34612-6.
40.	王永平, 周歡粉, 付俊霞, 等. 放射性視神經病變的臨床和影像學特征分析[J]. 中華眼底病雜志, 2022, 38(12): 994-1000. DOI: 10.3760/cma.j.cn511434-20210825-00459.Wang YP, Zhou HF, Fu JX, et al. Analysis of clinical and imaging characteristics of radiation-induced optic neuritis[J]. Chin J Ocul Fundus Dis, 2022, 38(12): 994-1000. DOI: 10.3760/cma.j.cn511434-20210825-00459.
41.	Hudgins PA, Newman NJ, Dillon WP, et al. Radiation-induced optic neuropathy: characteristic appearances on gadolinium-enhanced MR[J]. AJNR Am J Neuroradiol, 1992, 13(1): 235-238.
42.	徐全剛. 與腫瘤相關的視神經病變[J]. 中國眼耳鼻喉科雜志, 2022, 22(1): 3-6. DOI: 10.14166/j.issn.1671-2420.2022.01.002.Xu QG. Tumor-associated optic neuropathy[J]. Chin J Ophthalmol and Otorhinolaryngol, 2022, 22(1): 3-6. DOI: 10.14166/j.issn.1671-2420.2022.01.002.
43.	Guy J, Schatz NJ. Hyperbaric oxygen in the treatment of radiation-induced optic neuropathy[J]. Ophthalmology, 1986, 93(8): 1083-1088. DOI: 10.1016/s0161-6420(86)33617-0.
44.	Lessell S. Friendly fire: neurogenic visual loss from radiation therapy[J]. J Neuroophthalmol, 2004, 24(3): 243-250. DOI: 10.1097/00041327-200409000-00014.
45.	Roden D, Bosley TM, Fowble B, et al. Delayed radiation injury to the retrobulbar optic nerves and chiasm. Clinical syndrome and treatment with hyperbaric oxygen and corticosteroids[J]. Ophthalmology, 1990, 97(3): 346-351. DOI: 10.1016/s0161-6420(90)32582-4.
46.	Shields CL, Demirci H, Marr BP, et al. Intravitreal triamcinolone acetonide for acute radiation papillopathy[J]. Retina, 2006, 26(5): 537-544. DOI: 10.1097/00006982-200605000-00007.
47.	AlAmeer AM, Davis JB, Carey AR, et al. Outcomes of systemic bevacizumab in radiation-induced optic neuropathy, case series[J]. J Neurooncol, 2023, 163(2): 439-446. DOI: 10.1007/s11060-023-04346-y.
48.	Finger PT, Chin KJ. Antivascular endothelial growth factor bevacizumab for radiation optic neuropathy: secondary to plaque radiotherapy[J]. Int J Radiat Oncol Biol Phys, 2012, 82(2): 789-798. DOI: 10.1016/j.ijrobp.2010.11.075.
49.	Victor AA, Andayani G, Djatikusumo A, et al. Efficacy of prophylactic anti-VEGF in preventing radiation retinopathy: a systematic review and meta-analysis[J]. Clin Ophthalmol, 2023, 17: 2997-3009. DOI: 10.2147/OPTH.S433531.

1. Leber KA, Bergl?ff J, Pendl G. Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery[J]. J Neurosurg, 1998, 88(1): 43-50. DOI: 10.3171/jns.1998.88.1.0043.
2. Ataídes FG, Silva SFBR, Baldin JJCMC. Radiation-induced optic neuropathy: literature review[J]. Neuro-Ophthalmology, 2020, 45(3): 172-180. DOI: 10.1080/01658107.2020.1817946.
3. Carey AR, Page BR, Miller N. Radiation-induced optic neuropathy: a review[J]. Br J Ophthalmol, 2023, 107(6): 743-749. DOI: 10.1136/bjo-2022-322854.
4. 張燕, 李紅陽, 彭春霞, 等. 放射性視神經病變的診療特征[J]. 國際眼科雜志, 2014, 14(6): 1095-1099. DOI: 10.3980/j.issn.1672-5123.2014.06.31.Zhang Y, Li HY, Peng CX, et al. Diagnosis and treatment characteristics of radioactive optic neuropathy[J]. Int Eye Sci, 2014, 14(6): 1095-1099. DOI: 10.3980/j.issn.1672-5123.2014.06.31.
5. Hall WA, Das JM. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT)[M/OL]. StatPearls. Treasure Island (FL): StatPearls Publishing, 2025. https://www.ncbi.nlm.nih.gov/sites/books/NBK542166/.
6. Seung SK, Larson DA, Galvin JM, et al. American college of radiology (ACR) and American society for radiation oncology (ASTRO) practice guideline for the performance of stereotactic radiosurgery (SRS)[J]. Am J Clin Oncol, 2013, 36(3): 310-315. DOI: 10.1097/COC.0b013e31826e053d.
7. Kinaci-Tas B, Alderliesten T, Verbraak FD, et al. Radiation-induced retinopathy and optic neuropathy after radiation therapy for brain, head, and neck tumors: a systematic review[J/OL]. Cancers, 2023, 15(7): 1999[2023-03-27]. https://pubmed.ncbi.nlm.nih.gov/37046660/. DOI: 10.3390/cancers15071999.
8. Peters DR, Asher A, Conti A, et al. Single fraction and hypofractionated radiosurgery for perioptic meningiomas—tumor control and visual outcomes: a systematic review and meta-analysis[J/OL]. Neurosurg Rev, 2023, 46(1): 287[2023-10-28]. https://pubmed.ncbi.nlm.nih.gov/37897519/. DOI: 10.1007/s10143-023-02197-9.
9. Asuzu DT, Bunevicius A, Kormath Anand R, et al. Clinical and radiologic outcomes after stereotactic radiosurgery for meningiomas in direct contact with the optic apparatus: an international multicenter study[J]. J Neurosurg, 2021, 136(4): 1070-1076. DOI: 10.3171/2021.3.JNS21328.
10. Hasegawa T, Kobayashi T, Kida Y. Tolerance of the optic apparatus in single-fraction irradiation using stereotactic radiosurgery[J]. Neurosurgery, 2010, 66(4): 688-695. DOI: 10.1227/01.NEU.0000367554.96981.26.
11. Paek SH, Downes MB, Bednarz G, et al. Integration of surgery with fractionated stereotactic radiotherapy for treatment of nonfunctioning pituitary macroadenomas[J]. Int J Radiat Oncol Biol Phys, 2005, 61(3): 795-808. DOI: 10.1016/j.ijrobp.2004.07.688.
12. Deng MY, Rauh S, Anil G, et al. Analysis of safety and efficacy of proton radiotherapy for optic nerve sheath meningioma[J/OL]. Neurooncol Adv, 2024, 6(1): vdae160[2024-09-21]. https://pubmed.ncbi.nlm.nih.gov/39434923/. DOI: 10.1093/noajnl/vdae160.
13. K?the A, Feuvret L, Weber DC, et al. Assessment of radiation-induced optic neuropathy in a multi-institutional cohort of chordoma and chondrosarcoma patients treated with proton therapy[J/OL]. Cancers, 2021, 13(21): 5327[2021-10-23]. https://pubmed.ncbi.nlm.nih.gov/34771490/. DOI: 10.3390/cancers13215327.
14. Astradsson A, Wiencke AK, Munck af Rosenschold P, et al. Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors[J]. J Neurooncol, 2014, 118(1): 101-108. DOI: 10.1007/s11060-014-1399-0.
15. Chen HY, Chuang CC, Chen HC, et al. Clinical outcomes of fractionated stereotactic radiosurgery in treating perioptic meningiomas and schwannomas: a single-institutional experience[J]. J Clin Neurosci, 2020, 81: 409-415. DOI: 10.1016/j.jocn.2020.09.058.
16. Farzin M, Molls M, Kampfer S, et al. Optic toxicity in radiation treatment of meningioma: a retrospective study in 213 patients[J]. J Neurooncol, 2016, 127(3): 597-606. DOI: 10.1007/s11060-016-2071-7.
17. Wu YL, Li WF, Yang KB, et al. Long-term evaluation and normal tissue complication probability (NTCP) models for predicting radiation-induced optic neuropathy after intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma: a large retrospective study in China[J/OL]. J Oncol, 2022, 2022: 3647462[2022-02-23]. https://pubmed.ncbi.nlm.nih.gov/35251172/. DOI: 10.1155/2022/3647462.
18. Piquemal R, Cottier JP, Arsène S, et al. Radiation-induced optic neuropathy 4 years after radiation: report of a case followed up with MRI[J]. Neuroradiology, 1998, 40(7): 439-441. DOI: 10.1007/s002340050619.
19. Wang Y, Fu J, Zhou H, et al. Clinical characteristics of radiation-induced optic neuropathy: a single-center retrospective study[J]. Adv Ophthalmol Pract Res, 2023, 3(3): 141-146. DOI: 10.1016/j.aopr.2023.05.003.
20. Milano MT, Grimm J, Soltys SG, et al. Single-and multi-fraction stereotactic radiosurgery dose tolerances of the optic pathways[J]. Int J Radiat Oncol Biol Phys, 2021, 110(1): 87-99. DOI: 10.1016/j.ijrobp.2018.01.053.
21. Kim JO, Ma R, Akagami R, et al. Long-term outcomes of fractionated stereotactic radiation therapy for pituitary adenomas at the BC cancer agency[J]. Int J Radiat Oncol Biol Phys, 2013, 87(3): 528-533. DOI: 10.1016/j.ijrobp.2013.06.2057.
22. Fuji H, Nakasu Y, Ishida Y, et al. Feasibility of proton beam therapy for chordoma and chondrosarcoma of the skull base[J]. Skull Base, 2011, 21(3): 201-206. DOI: 10.1055/s-0031-1275636.
23. Brecht S, Boda-Heggemann J, Budjan J, et al. Radiation-induced optic neuropathy after stereotactic and image guided intensity-modulated radiation therapy (IMRT)[J]. Radiother Oncol, 2019, 134: 166-177. DOI: 10.1016/j.radonc.2019.02.003.
24. Kountouri M, Pica A, Walser M, et al. Radiation-induced optic neuropathy after pencil beam scanning proton therapy for skull-base and head and neck tumours[J/OL]. Br J Radiol, 2020, 93(1107): 20190028[2019-08-01]. https://pubmed.ncbi.nlm.nih.gov/31322969/. DOI: 10.1259/bjr.20190028.
25. Demizu Y, Murakami M, Miyawaki D, et al. Analysis of vision loss caused by radiation-induced optic neuropathy after particle therapy for head-and-neck and skull-base tumors adjacent to optic nerves[J]. Int J Radiat Oncol Biol Phys, 2009, 75(5): 1487-1492. DOI: 10.1016/j.ijrobp.2008.12.068.
26. Doroslova?ki P, Tamhankar MA, Liu GT, et al. Factors sssociated with occurrence of radiation-induced optic neuropathy at “safe” radiation dosage[J]. Semin Ophthalmol, 2018, 33(4): 581-588. DOI: 10.1080/08820538.2017.1346133.
27. Lecornu M, Lesueur P, Salleron J, et al. Prospective assessment of early proton therapy-induced optic neuropathy in patients with intracranial, orbital or sinonasal tumors: impact of a standardized ophthalmological follow up[J/OL]. Front Oncol, 2021, 11: 673886[2021-06-15]. https://pubmed.ncbi.nlm.nih.gov/34211847/. DOI: 10.3389/fonc.2021.673886.
28. Xiang M, Chan C, Wang L, et al. Physiological motion of the optic chiasm and its impact on stereotactic radiosurgery dose[J/OL]. Br J Radiol, 2019, 92(1099): 20190170[2019-05-22]. https://pubmed.ncbi.nlm.nih.gov/31067077/. DOI: 10.1259/bjr.20190170.
29. Qing K, Nie K, Liu B, et al. The impact of optic nerve movement on intracranial radiation treatment[J/OL]. Front Oncol, 2022, 12: 803329[2022-02-24]. https://pubmed.ncbi.nlm.nih.gov/35280734/. DOI: 10.3389/fonc.2022.803329.
30. Ferguson I, Huecker J, Huang J, et al. Risk factors for radiation-induced optic neuropathy: a case-control study[J]. Clin Exp Ophthalmol, 2017, 45(6): 592-597. DOI: 10.1111/ceo.12927.
31. Young WC, Thornton AF, Gebarski SS, et al. Radiation-induced optic neuropathy: correlation of MR imaging and radiation dosimetry[J]. Radiology, 1992, 185(3): 904-907. DOI: 10.1148/radiology.185.3.1438784.
32. Oakey Z, Ye?ilta? YS, Singh AD. Radiation optic neuropathy: management options[J]. Ocul Oncol Pathol, 2023, 9(5-6): 166-171. DOI: 10.1159/000533426.
33. Rong R, Xia X, Peng H, et al. Cdk5-mediated Drp1 phosphorylation drives mitochondrial defects and neuronal apoptosis in radiation-induced optic neuropathy[J/OL]. Cell Death Dis, 2020, 11(9): 720[2020-09-03]. https://pubmed.ncbi.nlm.nih.gov/32883957/. DOI: 10.1038/s41419-020-02922-y.
34. Yang J, Li Q, Han D, et al. Radiation-induced impairment of optic nerve axonal transport in tree shrews and rats monitored by longitudinal manganese-enhanced MRI[J]. Neurotoxicology, 2020, 77: 145-154. DOI: 10.1016/j.neuro.2020.01.008.
35. Archer EL, Liao EA, Trobe JD. Radiation-induced optic neuropathy: clinical and imaging profile of twelve patients[J]. J Neuroophthalmol, 2019, 39(2): 170-180. DOI: 10.1097/WNO.0000000000000670.
36. Pham TN, Mathis T, Azemar N, et al. Connecting visual perception with proton therapy-induced optic damage using archetypal analysis[J/OL]. Int J Part Ther, 2025, 18: 101211[2025-11-06]. https://pubmed.ncbi.nlm.nih.gov/41459013/. DOI: 10.1016/j.ijpt.2025.101211.
37. Koné AS, Diakité AS, Ahid IM, et al. LENT SOMA tables[J]. Radiother Oncol, 1995, 35(1): 17-60.
38. Baroni LV, Alderete D, Solano-Paez P, et al. Bevacizumab for pediatric radiation necrosis[J]. Neurooncol Pract, 2020, 7(4): 409-414. DOI: 10.1093/nop/npz072.
39. Brown GC, Shields JA, Sanborn G, et al. Radiation optic neuropathy[J]. Ophthalmology, 1982, 89(12): 1489-1493. DOI: 10.1016/s0161-6420(82)34612-6.
40. 王永平, 周歡粉, 付俊霞, 等. 放射性視神經病變的臨床和影像學特征分析[J]. 中華眼底病雜志, 2022, 38(12): 994-1000. DOI: 10.3760/cma.j.cn511434-20210825-00459.Wang YP, Zhou HF, Fu JX, et al. Analysis of clinical and imaging characteristics of radiation-induced optic neuritis[J]. Chin J Ocul Fundus Dis, 2022, 38(12): 994-1000. DOI: 10.3760/cma.j.cn511434-20210825-00459.
41. Hudgins PA, Newman NJ, Dillon WP, et al. Radiation-induced optic neuropathy: characteristic appearances on gadolinium-enhanced MR[J]. AJNR Am J Neuroradiol, 1992, 13(1): 235-238.
42. 徐全剛. 與腫瘤相關的視神經病變[J]. 中國眼耳鼻喉科雜志, 2022, 22(1): 3-6. DOI: 10.14166/j.issn.1671-2420.2022.01.002.Xu QG. Tumor-associated optic neuropathy[J]. Chin J Ophthalmol and Otorhinolaryngol, 2022, 22(1): 3-6. DOI: 10.14166/j.issn.1671-2420.2022.01.002.
43. Guy J, Schatz NJ. Hyperbaric oxygen in the treatment of radiation-induced optic neuropathy[J]. Ophthalmology, 1986, 93(8): 1083-1088. DOI: 10.1016/s0161-6420(86)33617-0.
44. Lessell S. Friendly fire: neurogenic visual loss from radiation therapy[J]. J Neuroophthalmol, 2004, 24(3): 243-250. DOI: 10.1097/00041327-200409000-00014.
45. Roden D, Bosley TM, Fowble B, et al. Delayed radiation injury to the retrobulbar optic nerves and chiasm. Clinical syndrome and treatment with hyperbaric oxygen and corticosteroids[J]. Ophthalmology, 1990, 97(3): 346-351. DOI: 10.1016/s0161-6420(90)32582-4.
46. Shields CL, Demirci H, Marr BP, et al. Intravitreal triamcinolone acetonide for acute radiation papillopathy[J]. Retina, 2006, 26(5): 537-544. DOI: 10.1097/00006982-200605000-00007.
47. AlAmeer AM, Davis JB, Carey AR, et al. Outcomes of systemic bevacizumab in radiation-induced optic neuropathy, case series[J]. J Neurooncol, 2023, 163(2): 439-446. DOI: 10.1007/s11060-023-04346-y.
48. Finger PT, Chin KJ. Antivascular endothelial growth factor bevacizumab for radiation optic neuropathy: secondary to plaque radiotherapy[J]. Int J Radiat Oncol Biol Phys, 2012, 82(2): 789-798. DOI: 10.1016/j.ijrobp.2010.11.075.
49. Victor AA, Andayani G, Djatikusumo A, et al. Efficacy of prophylactic anti-VEGF in preventing radiation retinopathy: a systematic review and meta-analysis[J]. Clin Ophthalmol, 2023, 17: 2997-3009. DOI: 10.2147/OPTH.S433531.

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