PURPOSE: To report a case of blindness caused by a white-matter injury after whole brain irradiation for metastatic renal cell carcinoma. METHODS: Case report. We performed comprehensive serial neuro-ophthalmologic examinations. RESULTS: Four to 5 months after resection of renal cell metastasis in the left occipital cortex, interleukin-2 therapy, and whole brain irradiation with 3,000 cGy plus a 1,500-cGy boost to the posterior third of the brain, the patient developed a progressive decline in visual acuity in both eyes to hand motions. Magnetic resonance imaging disclosed signal abnormalities without mass effect in the white matter of the parietal and occipital lobes bilaterally, including the optic radiations. CONCLUSION: This case is a unique example of cortical blindness secondary to radiation injury in the occipital lobes and optic radiations.
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