PubTransformer

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PMID- 28763558
OWN - NLM
STAT- MEDLINE
DA  - 20170801
DCOM- 20170803
LR  - 20170803
IS  - 1552-5783 (Electronic)
IS  - 0146-0404 (Linking)
VI  - 58
IP  - 10
DP  - 2017 Aug 01
TI  - Radiation Maculopathy After Proton Beam Therapy for Uveal Melanoma: Optical
      Coherence Tomography Angiography Alterations Influencing Visual Acuity.
PG  - 3851-3861
LID - 10.1167/iovs.17-22324 [doi]
AB  - Purpose: 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). Methods: 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. Results:
      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. Conclusions: VA of eyes with
      radiation maculopathy is influenced by structural and microvascular factors
      identified with OCTA, including FAZ area and DCP integrity.
FAU - Matet, Alexandre
AU  - Matet A
AD  - Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital,
      Fondation Asile des Aveugles, Lausanne, Switzerland.
FAU - Daruich, Alejandra
AU  - Daruich A
AD  - Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital,
      Fondation Asile des Aveugles, Lausanne, Switzerland.
FAU - Zografos, Leonidas
AU  - Zografos L
AD  - Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital,
      Fondation Asile des Aveugles, Lausanne, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Invest Ophthalmol Vis Sci
JT  - Investigative ophthalmology & visual science
JID - 7703701
RN  - Uveal melanoma
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Fluorescein Angiography
MH  - Fovea Centralis/pathology
MH  - Humans
MH  - Macula Lutea/*pathology
MH  - Male
MH  - Melanoma/*radiotherapy
MH  - Middle Aged
MH  - Proton Therapy/*adverse effects
MH  - Radiation Injuries/*etiology/pathology/physiopathology
MH  - Retinal Diseases/*etiology/pathology/physiopathology
MH  - Retinal Vessels/pathology
MH  - Retrospective Studies
MH  - Tomography, Optical Coherence
MH  - Uveal Neoplasms/*radiotherapy
MH  - Visual Acuity/physiology
EDAT- 2017/08/02 06:00
MHDA- 2017/08/05 06:00
CRDT- 2017/08/02 06:00
AID - 2646833 [pii]
AID - 10.1167/iovs.17-22324 [doi]
PST - ppublish
SO  - Invest Ophthalmol Vis Sci. 2017 Aug 1;58(10):3851-3861. doi:
      10.1167/iovs.17-22324.