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array:24 [ "pii" => "S2173579417301056" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.05.008" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1138" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:486-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669117300138" "issn" => "03656691" "doi" => "10.1016/j.oftal.2016.11.017" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1138" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:486-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 46 "formatos" => array:2 [ "HTML" => 34 "PDF" => 12 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicaciones cortas</span>" "titulo" => "Retinopatía por radiación secundaria a tratamiento de carcinoma de seno maxilar: un caso dramático" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "486" "paginaFinal" => "489" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Radiation retinopathy secondary to treatment of maxillary sinus carcinoma: a dramatic case" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2040 "Ancho" => 2667 "Tamanyo" => 712848 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Retinopatía por radiación ojo derecho (fase inicial).</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A) Retinografía: hemorragias y exudados algodonosos en retina nasal e inferior.</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">B) Tomografía de coherencia óptica: edema macular con pequeño desprendimiento neurosensorial subfoveal.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">C) Angiografía fluoresceínica: hiperfluorescencia en arcadas a nivel peripapilar y efecto pantalla de hemorragias retinianas.</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">D) Angiografía fluoresceínica: isquemia periférica en retina inferior.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. 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"apellidos" => "García-Alonso" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417301056" "doi" => "10.1016/j.oftale.2017.05.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301056?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117300138?idApp=UINPBA00004N" "url" => "/03656691/0000009200000010/v1_201709270108/S0365669117300138/v1_201709270108/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579417300683" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.010" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1106" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:490-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6 "formatos" => array:2 [ "HTML" => 3 "PDF" => 3 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "490" "paginaFinal" => "494" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Coriorretinitis placoide posterior sifilítica como presentación inicial de neurosífilis temprana" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 616 "Ancho" => 1900 "Tamanyo" => 151234 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Retinographs: (a) papillary edema without macular compromise; (b) papillary edema with yellowish plaque in the posterior pole involving the macula; (c) autofluorescence showing hyperautofluorescence areas.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F.E. Molina-Sócola, F. López-Herrero, A. Medina-Tapia, T. Rueda-Rueda, M. Contreras-Díaz, J.L. Sánchez-Vicente" "autores" => array:6 [ 0 => array:2 [ "nombre" => "F.E." "apellidos" => "Molina-Sócola" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "López-Herrero" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Medina-Tapia" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Rueda-Rueda" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Contreras-Díaz" ] 5 => array:2 [ "nombre" => "J.L." "apellidos" => "Sánchez-Vicente" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669116302222" "doi" => "10.1016/j.oftal.2016.10.019" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669116302222?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300683?idApp=UINPBA00004N" "url" => "/21735794/0000009200000010/v1_201709270057/S2173579417300683/v1_201709270057/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417301068" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.05.009" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1148" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:481-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Bilateral exudative retinal detachment associated with central serous chorioretinopathy in a patient treated with corticosteroids" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "481" "paginaFinal" => "485" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Desprendimiento de retina exudativo bilateral asociado con coriorretinopatía serosa central en una paciente tratada con corticoesteroides" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1208 "Ancho" => 2500 "Tamanyo" => 249452 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Final stage of 2 eyes. Intense subretinal fibrosis, RPE atrophy and hypertrophy and epiretinal membranes.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. Rueda-Rueda, J.L. Sánchez-Vicente, L. Llerena-Manzorro, A. Medina-Tapia, L. González-García, A. Alfaro-Juárez, C. Vital-Berral, F. López-Herrero, A. Muñoz-Morales, L.S. Ortega, Á. Herrador-Montiel" "autores" => array:11 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Rueda-Rueda" ] 1 => array:2 [ "nombre" => "J.L." "apellidos" => "Sánchez-Vicente" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Llerena-Manzorro" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Medina-Tapia" ] 4 => array:2 [ "nombre" => "L." "apellidos" => "González-García" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Alfaro-Juárez" ] 6 => array:2 [ "nombre" => "C." "apellidos" => "Vital-Berral" ] 7 => array:2 [ "nombre" => "F." "apellidos" => "López-Herrero" ] 8 => array:2 [ "nombre" => "A." "apellidos" => "Muñoz-Morales" ] 9 => array:2 [ "nombre" => "L.S." "apellidos" => "Ortega" ] 10 => array:2 [ "nombre" => "Á." "apellidos" => "Herrador-Montiel" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300230" "doi" => "10.1016/j.oftal.2017.01.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117300230?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301068?idApp=UINPBA00004N" "url" => "/21735794/0000009200000010/v1_201709270057/S2173579417301068/v1_201709270057/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Radiation retinopathy secondary to treatment of maxillary sinus carcinoma: A dramatic case" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "486" "paginaFinal" => "489" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Galindo-Bocero, S. Macías-Franco, S. Sánchez-García, M. Fonollá-Gil, A. García-Alonso" "autores" => array:5 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Galindo-Bocero" "email" => array:1 [ 0 => "javiergalindobocero@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Macías-Franco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "S." "apellidos" => "Sánchez-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Fonollá-Gil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "García-Alonso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Oftalmología, Fundación Hospital de Jove, Gijón, Asturias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Retinopatía por radiación secundaria a tratamiento de carcinoma de seno maxilar: un caso dramático" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 916 "Ancho" => 1600 "Tamanyo" => 142560 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Facial CAT with intravenous contrast. Right maxillary tumor (arrows) involving the destruction of all maxillary sinus walls with medial extension toward the nasal fossa (A) and cranial toward the orbit (B).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Radiation toxicity could affect any structure of the eyes. One of the most feared expressions is radiation retinopathy that courses with severe and insidious vision impairment, which could develop after intraocular tumor radiotherapy or irradiation of malign sinus, orbital of pharyngeal neoplasias.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinical case</span><p id="par0010" class="elsevierStylePara elsevierViewall">Male patient, 53, diagnosed with undifferentiated right maxillary sinus carcinoma in stage <span class="elsevierStyleSmallCaps">IV</span> (T4N0M0), with a size of approximately 60<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>55<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>45<span class="elsevierStyleHsp" style=""></span>mm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The tumor is considered to be non-resectable and it was decided to apply 4 chemotherapy cycles with the TPF regime (docetaxel<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>cisplatin<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>fluorouracyl) with minimum response, which led to the application of radical radiotherapy with a total dose of 70<span class="elsevierStyleHsp" style=""></span>Gy (divided in 35 sessions of 2<span class="elsevierStyleHsp" style=""></span>Gy each).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The patient began to exhibit progressive visual acuity (VA) loss in the right eye 18 months after irradiation. Exploration confirmed diminished VA in right eye (0.6) when compared to the left eye (1.0). Right eye examination revealed scleral vessel dilatation, posterior subcapsular cataracts, incipient macular edema, cotton wool hemorrhages and exudates in the nasal and inferior retina as well as inferior peripheral ischemia in angiography (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). No alterations were observed in the left eye. Computerized action tomography and magnetic nuclear angioresonance discarded progression of the tumor and other possible causes. Accordingly, clinic pointed to ocular toxicity secondary to radiation.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Retinal panphotocoagulation and focal laser were performed sequentially, followed by cataract surgery with intraocular lens implant in posterior chamber and 4 intravitreal injections of bevacizumab. Despite said treatment, VA progressively deteriorated in the course of 12 months follow-up, with panretinal ischemia extension and macular edema worsening, with VA diminishing to <0.01.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Evolution was torpid and evolved to massive subretinal exudation in posterior pole and nasal retina (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), leading to complete exudative retina detachment, hemophthalmos and secondary malign glaucoma. The patient did not perceive light and medical treatment failed to control intraocular pressure. Accordingly, evisceration was decided due to painful blind eye 4 years after onset of symptoms and nearly 6 years after irradiation.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Radiation retinopathy was described by H.B. Stallard in 1933. At that time, the retina was considered to be radio-resistant tissue together with the central nervous system.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The time interval between exposure to radiation energy and the appearance of retinal lesions is variable and unpredictable. Clinical changes were observed in laboratory retinas after 3 weeks, although typically retinopathy appears between 6 months and 3 years after treatment<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> although some reports describe retinopathy cases appearing up to 15 years after irradiation.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Incidence mainly depends on the overall dose and the size of the administered fraction. Some studies demonstrate clear increased risk with total dosages above 45–50<span class="elsevierStyleHsp" style=""></span>Gy or fractions exceeding 1.8–2.0<span class="elsevierStyleHsp" style=""></span>Gy.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,5</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">As in diabetic retinopathy, histopathological and ultrastructural studies confirmed that the first event in radiation retinopathy is occlusive microvasculopathy with loss of endothelial cells and closure of capillaries<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> which in the long-term induce ischemic and vasoproliferative changes. The retina posterior pole is more sensitive than the periphery.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,7</span></a> Patients with previous chemotherapy treatment could exhibit more severe forms of retinopathy.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Macular edema is the main cause of visual impairment, although with less frequency it can appear as acute optical neuropathy. In late stages of the disease, the ischemic component predominates and accounts for the appearance of neovascular complications that could significantly influence prognosis.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,7</span></a> In these cases evisceration or enucleation could be necessary due to painful blind eye.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Diagnostic is predominantly clinic, with optical coherence tomography and fluorescein angiography being very useful to determine the degree of subretinal exudation and ischemia. In the presence of the latter, retinal photocoagulation is an attempt to prevent the appearance of neovascular complications. Therapeutic options for macular edema include laser and intravitreal injections of triamcinolone or anti-VEGF.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5,7</span></a> Recently, intravitreal dexamethasone implants have demonstrated good results in refractory maculopathy cases.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Radiation retinopathy is an infrequent pathology which nonetheless must be taken into account in the presence of vision loss in patients with neck and head irradiation. Radiotherapy is increasingly used for treating ocular and orbital tumors, for which reason the prevalence and incidence of this disease are on the increase.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Long-term ophthalmological follow-up is crucial for early diagnostic, which in turn is essential to halt the progression of the disease.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interests</span><p id="par0060" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres906146" "titulo" => "Abstract" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec886589" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres906147" "titulo" => "Resumen" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec886590" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-10-30" "fechaAceptado" => "2016-11-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec886589" "palabras" => array:5 [ 0 => "Eye evisceration" 1 => "Maxillary sinus carcinoma" 2 => "Head and neck irradiation" 3 => "Radiotherapy" 4 => "Radiation retinopathy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec886590" "palabras" => array:5 [ 0 => "Evisceración ocular" 1 => "Carcinoma de seno maxilar" 2 => "Irradiación de cabeza y cuello" 3 => "Radioterapia" 4 => "Retinopatía por radiación" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Clinical case</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 53-year old male presented with visual impairment in right eye after irradiation of right maxillary sinus carcinoma. Funduscopy shows radiation retinopathy: hemorrhages, exudates, macular edema, and peripheral retinal ischemia. A poor outcome was achieved despite laser treatment and intravitreal injections of bevacizumab, resulting in evisceration of the affected eye.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Radiation retinopathy must be considered in any loss of vision after head and neck irradiation. Ophthalmological long-term follow-up of these patients is essential for an early diagnosis.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Un varón de 53 años consulta por pérdida de visión en ojo derecho tras irradiación de carcinoma de seno maxilar derecho. La exploración funduscópica muestra hemorragias, exudados, edema macular e isquemia retiniana periférica, compatibles con una retinopatía por radiación. La evolución es tórpida a pesar de tratamiento con láser e inyecciones intravítreas de bevacizumab, finalizando en evisceración del ojo afecto.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La retinopatía por radiación debe tenerse en cuenta ante cualquier pérdida de visión tras irradiación de cabeza y cuello. El seguimiento oftalmológico a largo plazo de estos pacientes es fundamental para conseguir un diagnóstico precoz.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Galindo-Bocero J, Macías-Franco S, Sánchez-García S, Fonollá-Gil M, García-Alonso A. Retinopatía por radiación secundaria a tratamiento de carcinoma de seno maxilar: un caso dramático. Arch Soc Esp Oftalmol. 2017;92:486–489.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 916 "Ancho" => 1600 "Tamanyo" => 142560 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Facial CAT with intravenous contrast. Right maxillary tumor (arrows) involving the destruction of all maxillary sinus walls with medial extension toward the nasal fossa (A) and cranial toward the orbit (B).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2040 "Ancho" => 2667 "Tamanyo" => 712848 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Radiation retinopathy in right eye (initial stage). (A) Retinograph: cotton wool hemorrhages and exudates in nasal and inferior retina. (B) Optical coherence tomography showing macular edema with small subfoveal neurosensory detachment. (C) Fluorescein angiography: hyperfluorescence in peripapillary arches and screen effect of retinal hemorrhages. (D) Fluorescein angiography: peripheral ischemia in the inferior retina.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 973 "Ancho" => 2833 "Tamanyo" => 464693 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Radiation retinopathy in right eye (terminal stage). (A) Retinograph: massive subretinal exudation in posterior pole. 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