Abstract
Radiation chorioretinopathy, radiation maculopathy, and radiation optic neuropathy are the major complications of ophthalmic radiotherapy. Optical coherence tomography (OCT) and OCT angiography (OCTA) are revolutionary imaging methods, allowing the visualization of the retinal cellular architecture and the retinal vascular system, respectively. In recent years this multimodal imaging approach has been applied to several retinal disease, but its role in the clinical characterization of retinal complications secondary to ophthalmic radiotherapy has not yet been defined. The purpose of this review is to critically evaluate the role of OCT and OCTA in the clinical assessment of radiation-induced chorioretinopathy, maculopathy, and optic neuropathy.
Highlights
Imaging of the posterior segment of the eye is playing a fundamental role in ocular oncology, in the differential diagnosis of intraocular tumors, and in the clinical characterization of ocular side effects related to the intraocular tumor treatment, providing valuable structural, functional and morphological information on the chorioretinal complex and the visual pathway [1]
Radiotherapy offers an eye-sparing alternative for these patients, the Collaborative Ocular Melanoma Study (COMS) reported that 3 years post-treatment, nearly 50% of patients had a visual acuity of 20/200 or worse [2,3]
The application of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) technology in ocular oncology has evolved over many years by the efforts of many research groups and physicians to translate this technology from bench to bedside, and back again, with impressive results
Summary
Imaging of the posterior segment of the eye is playing a fundamental role in ocular oncology, in the differential diagnosis of intraocular tumors, and in the clinical characterization of ocular side effects related to the intraocular tumor treatment (mainly irradiation), providing valuable structural, functional and morphological information on the chorioretinal complex and the visual pathway [1]. Radiotherapy offers an eye-sparing alternative for these patients, the Collaborative Ocular Melanoma Study (COMS) reported that 3 years post-treatment, nearly 50% of patients had a visual acuity of 20/200 or worse [2,3]. The clinical presentation of chorioretinal damage, due to eye irradiation, occurs from 6 months to 5 years after radiotherapy, and this damage may cause visual acuity loss (42% at 5 years) [4]. The prevention and the management of these complications are still limited, but in the retinal multimodal imaging era it may be useful to have a precocious identification and classification of major chorioretinal complications due to eye irradiation: Radiation chorioretinopathy (Figure 1), radiation maculopathy (Figures 1 and 2), and radiation optic neuropathy (Figures 1 and 3) [5,6,7,8,9,10]
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