Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography
In this prospective study, we investigated the structural and vascular retinal changes at baseline and after Ranibizumab injections at the last follow up to one year in patients affected by Radiation Maculopathy (RM) after plaque brachytheraphy in choroidal melanoma, using Spectral Domain Optical Co...
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doaj-3dbefc4e790d44039e648faad2a9389d2020-11-25T03:10:41ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0191618161810.3390/jcm9061618Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography AngiographyGilda Cennamo0Daniela Montorio1Roberta Bernardo2Antonio Farella3Raffaele Liuzzi4Maria Angelica Breve5Michele Reibaldi6Giovanni Cennamo7Eye Clinic, Public Health Department, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, ItalyFunctional and Morphologic Department of Radiotherapy and Legal Medicine, University of Naples “Federico II”, 80131 Naples, ItalyInstitute of Biostructure and Bioimaging, National Research Council (CNR), 80145 Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Surgical Sciences, University of Torino, 10124 Torino, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, ItalyIn this prospective study, we investigated the structural and vascular retinal changes at baseline and after Ranibizumab injections at the last follow up to one year in patients affected by Radiation Maculopathy (RM) after plaque brachytheraphy in choroidal melanoma, using Spectral Domain Optical Coherence Tomography (SD-OCT) and OCT Angiography (OCTA). A total of 40 eyes with RM of 40 patients (18 females, 22 males, mean age 51.9 ± 11 years) that underwent ruthenium-106 plaque brachytherapy were included. All patients received one monthly intravitreal injection of Ranibizumab (Pro Re Nata regimen). We analyzed the Foveal Avascular Zone (FAZ) area, the retinal vessel density (VD) of the superficial capillary plexus (SCP) and of the deep capillary plexus (DCP), using OCTA, and we detected the Central Foveal Thickness (CFT) by SD-OCT at baseline and after treatment. At the last follow up, we found a significant improvement of the CFT (<i>p</i><i> </i>< 0.001) while OCTA parameters revealed no change in VD of the SCP (<i>p</i> = 0.402), DCP (<i>p</i> = 0.282), and FAZ area (<i>p</i> = 0.255), resulting in a stabilization of the visual acuity (<i>p</i> = 0.210) respect to baseline. The absence of functional improvement, despite the anatomical recovery of the macula, could be due to the absence of improvement in FAZ area and in retinal VD after treatment. OCTA parameters could represent predictive biomarkers to anti-vascular endothelial growth factor (anti-VEGF) intravitreal response and to help to better understand the physiopathological mechanisms of the RM.https://www.mdpi.com/2077-0383/9/6/1618radiation maculopathyplaque brachytherapyoptical coherence tomography angiographyretinal vessel densityfoveal avascular zone |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gilda Cennamo Daniela Montorio Roberta Bernardo Antonio Farella Raffaele Liuzzi Maria Angelica Breve Michele Reibaldi Giovanni Cennamo |
spellingShingle |
Gilda Cennamo Daniela Montorio Roberta Bernardo Antonio Farella Raffaele Liuzzi Maria Angelica Breve Michele Reibaldi Giovanni Cennamo Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography Journal of Clinical Medicine radiation maculopathy plaque brachytherapy optical coherence tomography angiography retinal vessel density foveal avascular zone |
author_facet |
Gilda Cennamo Daniela Montorio Roberta Bernardo Antonio Farella Raffaele Liuzzi Maria Angelica Breve Michele Reibaldi Giovanni Cennamo |
author_sort |
Gilda Cennamo |
title |
Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography |
title_short |
Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography |
title_full |
Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography |
title_fullStr |
Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography |
title_full_unstemmed |
Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography |
title_sort |
retinal vascular changes in radiation maculopathy after intravitreal ranibizumab by optical coherence tomography angiography |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-05-01 |
description |
In this prospective study, we investigated the structural and vascular retinal changes at baseline and after Ranibizumab injections at the last follow up to one year in patients affected by Radiation Maculopathy (RM) after plaque brachytheraphy in choroidal melanoma, using Spectral Domain Optical Coherence Tomography (SD-OCT) and OCT Angiography (OCTA). A total of 40 eyes with RM of 40 patients (18 females, 22 males, mean age 51.9 ± 11 years) that underwent ruthenium-106 plaque brachytherapy were included. All patients received one monthly intravitreal injection of Ranibizumab (Pro Re Nata regimen). We analyzed the Foveal Avascular Zone (FAZ) area, the retinal vessel density (VD) of the superficial capillary plexus (SCP) and of the deep capillary plexus (DCP), using OCTA, and we detected the Central Foveal Thickness (CFT) by SD-OCT at baseline and after treatment. At the last follow up, we found a significant improvement of the CFT (<i>p</i><i> </i>< 0.001) while OCTA parameters revealed no change in VD of the SCP (<i>p</i> = 0.402), DCP (<i>p</i> = 0.282), and FAZ area (<i>p</i> = 0.255), resulting in a stabilization of the visual acuity (<i>p</i> = 0.210) respect to baseline. The absence of functional improvement, despite the anatomical recovery of the macula, could be due to the absence of improvement in FAZ area and in retinal VD after treatment. OCTA parameters could represent predictive biomarkers to anti-vascular endothelial growth factor (anti-VEGF) intravitreal response and to help to better understand the physiopathological mechanisms of the RM. |
topic |
radiation maculopathy plaque brachytherapy optical coherence tomography angiography retinal vessel density foveal avascular zone |
url |
https://www.mdpi.com/2077-0383/9/6/1618 |
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