Radiation retinopathy following plaque brachytherapy for choroidal melanoma. Progression of retinopathy over time. A, Image shows intraretinal hemorrhages and cotton-wool spots. Compared with other entities (such as diabetes) that can cause intraretinal hemorrhages and cotton-wool spots, radiation retinopathy causes many more of these spots relative to the extent of the hemorrhages. B, Eight months later, there is substantial progression of the retinopathy, with increased exudation and subretinal and intraretinal fluid in the macula. Visual acuity declined in the interim.