Radiation Maculopathy After Proton Beam Therapy for Uveal Melanoma: Optical Coherence Tomography Angiography Alterations Influencing Visual Acuity.

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State: Public
Version: Final published version
Serval ID
serval:BIB_836B7B8C311C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Radiation Maculopathy After Proton Beam Therapy for Uveal Melanoma: Optical Coherence Tomography Angiography Alterations Influencing Visual Acuity.
Journal
Investigative ophthalmology & visual science
Author(s)
Matet A., Daruich A., Zografos L.
ISSN
1552-5783 (Electronic)
ISSN-L
0146-0404
Publication state
Published
Issued date
01/08/2017
Peer-reviewed
Oui
Volume
58
Number
10
Pages
3851-3861
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
To analyze microvascular and structural changes in radiation maculopathy and their influence on visual acuity (VA), using optical coherence tomography (OCT) and OCT angiography (OCTA).
This was a retrospective analysis of consecutive patients with radiation maculopathy, 12 months or more after proton-beam irradiation for uveal melanoma, imaged with fluorescein angiography, OCT, and OCTA. Clinical parameters potentially affecting VA were recorded, including OCTA-derived metrics: foveal avascular zone (FAZ) area, vascular density, and local fractal dimension of the superficial (SCP) and deep capillary plexuses (DCP). Nonirradiated fellow eyes served as controls.
Ninety-three patients were included. FAZ was larger, while SCP/DCP capillary density and local fractal dimension were lower in the 35 irradiated than in the 35 fellow eyes (P < 0.0001). Microvascular alterations graded on fluorescein angiography (minimally damaged/disrupted/disorganized) were correlated to FAZ area and SCP/DCP density on OCTA (P < 0.01). By univariate analysis, worse VA was associated to macular detachment at presentation (P = 0.024), total macular irradiation (P = 0.0008), higher central macular thickness (CMT) (P = 0.019), higher absolute CMT variation (P < 0.0001), cystoid edema (P = 0.030), ellipsoid zone disruption (P = 0.002), larger FAZ (P < 0.0001), lower SCP (P = 0.001) and DCP capillary density (P < 0.0001), and lower SCP (P = 0.009) and DCP local fractal dimension (P < 0.0001). Two multivariate models with either capillary density or fractal dimension as covariate showed that younger age (P = 0.014/0.017), ellipsoid zone disruption (P = 0.034/0.019), larger FAZ (P = 0.0006/0.002), and lower DCP density (P = 0.008) or DCP fractal dimension (P = 0.012), respectively, were associated with worse VA.
VA of eyes with radiation maculopathy is influenced by structural and microvascular factors identified with OCTA, including FAZ area and DCP integrity.

Keywords
Adult, Aged, Aged, 80 and over, Female, Fluorescein Angiography, Fovea Centralis/pathology, Humans, Macula Lutea/pathology, Male, Melanoma/radiotherapy, Middle Aged, Proton Therapy/adverse effects, Radiation Injuries/etiology, Radiation Injuries/pathology, Radiation Injuries/physiopathology, Retinal Diseases/etiology, Retinal Diseases/pathology, Retinal Diseases/physiopathology, Retinal Vessels/pathology, Retrospective Studies, Tomography, Optical Coherence, Uveal Neoplasms/radiotherapy, Visual Acuity/physiology
Pubmed
Web of science
Open Access
Yes
Create date
05/09/2017 16:51
Last modification date
20/08/2019 14:43
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