• Severity of visual loss and latency of RON occurrence

    When reviewing reported cases of RON in acromegalic patients in whom total radiation dose and fraction size are reported (Table 2) –using the abovementioned search method – it appears that in 24 of 32 patients, in whom visual loss was specified, RON was bilateral in 17 patients (71%) and unilateral in seven patients (29%). Visual acuity was less than 2/10 in 35 of 41 RON affected eyes.
    It is generally proposed, that most cases of RON occur within 18 months after radiation therapy49. However, Table 2 shows that in eight of 30 patients (27%), RON developed more than 18 months after radiation therapy (median 12 months, range 5-120 months). Thus late development of RON can occur, indicating that the clinician should remain alert of this complication, even many years after radiation therapy.

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