Background: Radiation retinopathy is a chronic, gradually progressive retinal microangiopathy that can occur with variable latency after exposure to radiation of head and neck. Nasophargeal carcinoma is a frequent head and neck tumor of the south-East Asian countries. Case Presentation: A 54-year old Asian male presented with decreased vision for 2 years in left eye. He had diffuse cystoid macular edema, retinal hemorrhages, exudates, and telangiectatic vessels. In the right eye, he had focal macular edema, exudates, and micro-aneurysm. He had undergone external beam radiation for nasopharyngeal carcinoma 32 years ago. He was treated with several injections of Anti-vascular endothelial growth factors elsewhere for persistent macular edema secondary to vein occlusion in the left eye, and had fewer response. Conclusion: The chronic maculopathy responded to treatment with intra vitreal sustained-release dexamethasone implant (Ozurdex®) and laser photo coagulation.

Keywords: Case report, radiation retinopathy: external beam radiation, cystoid macular edema, dexamethasone implant, antiVEGFs.