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Macular features assessed by optical coherence tomography‐angiography after proton beam therapy for choroidal melanoma
Author(s) -
Lumbroso L.,
Sellam A.,
Coscas F.,
Dendale R.,
Levy C.,
Coscas G.,
Desjardins L.,
Cassoux N.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.03646
Subject(s) - medicine , choroid , ophthalmology , visual acuity , maculopathy , optical coherence tomography angiography , radiation therapy , choroidal melanoma , optical coherence tomography , radiology , melanoma , retinopathy , retina , optics , physics , cancer research , diabetes mellitus , endocrinology
Purpose To characterize the macular features of patients treated with proton beam therapy for choroidal melanoma ( CM ), using the optical coherence tomography‐angiography ( OCTA ). Methods Observational, retrospective, study included patients treated with proton beam therapy for a small CM . All the patients had undergone a full exam including: visual acuity, optical coherence tomography ( OCT B‐scan) and OCTA (Spectralis Heidelberg, Germany) focused on the 10 central degrees. Only patients that had received 100% of the dose to the macula were included. Vascular features of both plexuses, of the choriocapillaris and the choroid were analyzed in OCTA . Results 37 patients had undergone an OCTA following proton beam therapy for a small CM . Only 17 patients (9 men and 8 women) that had 100% of the dose to the macula were included in this study. The mean age of the patients was 56.6 years (28‐86). The mean follow‐up duration was 35.8 months (11‐72 months). The mean tumor thickness was 3.39 mm (1.3‐7 mm). 13 patients (76.5%) had a clinical radiation maculopathy, 8 patients (47.1%) had macular cysts on OCT B‐scan. All the patients (100%) had abnormalities on OCTA . Cysts were found in 9 patients (52.9%) mostly in the deep capillary plexus.The loss of the choriocapillaris was observed in 15 patients (88.2%). Choroid vessels were diminished (by size and density) in the macular area in 13 patients (76.5%). Conclusions OCTA permits earlier detection of micro vascular alterations on both plexuses that the post radiation origin is highly probable du to the important doses receivedPatients treated with proton beam therapy for CM with 100% of the dose to the macula, present some alterations at both plexuses but also a vascular rarefaction of the choriocapillaris and of the choroidal vessel.