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

Détails

Ressource 1Télécharger: i1552-5783-58-10-3851.pdf (2167.89 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_836B7B8C311C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Radiation Maculopathy After Proton Beam Therapy for Uveal Melanoma: Optical Coherence Tomography Angiography Alterations Influencing Visual Acuity.
Périodique
Investigative ophthalmology & visual science
Auteur(s)
Matet A., Daruich A., Zografos L.
ISSN
1552-5783 (Electronic)
ISSN-L
0146-0404
Statut éditorial
Publié
Date de publication
01/08/2017
Peer-reviewed
Oui
Volume
58
Numéro
10
Pages
3851-3861
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Résumé
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.

Mots-clé
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
Oui
Création de la notice
05/09/2017 17:51
Dernière modification de la notice
20/08/2019 15:43
Données d'usage