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Aramburu-González A, Zarrabeitia Carrandi J, Robles Elejalde CB, Quilez Larragan A. Radiation retinopathy vs. ocular ischemic syndrome: how to reach the diagnosis? ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024:S2173-5794(24)00112-9. [PMID: 38909892 DOI: 10.1016/j.oftale.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 05/05/2024] [Indexed: 06/25/2024]
Abstract
We present a case of diagnostic interest; we present the differential diagnosis and the complementary tests necessary to reach it, in addition to highlighting the importance of a correct collection of background and clinical history. A 54-year-old woman with a history of carcinoma of the floor of the mouth treated with radiotherapy and chemotherapy develops ischemic retinopathy. It was necessary to perform a systemic study and differential diagnosis with entities such as ocular ischemic syndrome and radiation retinopathy, due to the similarity in the clinical findings found. Radiation retinopathy should be ruled out in any patient with visual impairment and a history of radiotherapy treatment. A broad differential diagnosis and systemic study are required to rule out entities such as ocular ischemic syndrome and diabetic retinopathy, in addition to early treatment to avoid possible complications.
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Affiliation(s)
| | | | | | - A Quilez Larragan
- Servicio de Radiología, Hospital Universitario de Basurto, Bilbao, Spain
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2
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Ammari W, Zaghdoudi A, Berriche O, Messaoud R. Case Report: Optical coherence tomography angiography findings in radiation retinopathy. F1000Res 2023; 11:968. [PMID: 37771719 PMCID: PMC10523097 DOI: 10.12688/f1000research.122952.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 09/30/2023] Open
Abstract
We reported the observation of a 31-year-old female followed for a nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 75 Gray. The patient presented with a progressive decline in bilateral vision. Ophthalmologic examination revealed bilateral dry eye, posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The patient presented all ocular complications of radiotherapy. The most severe was radiation retinopathy. Performing optic coherence tomography angiography (OCT-A) earlier could have speeded up the diagnosis and led to a better prognosis. The OCT-A showed more pronounced macular edema in the right eye, and revealed enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor. Yet, we noted a non-improved visual acuity. The aim of this case report was to present the contribution of OCT-A in the diagnosis of radiation maculopathy and attribute these changes to ischemia at the level of the retinal vascular network.
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Affiliation(s)
- Wafa Ammari
- Ophthalmology, University Hospital Taher Sfar, Mahdia, 5100, Tunisia
| | - Asma Zaghdoudi
- Ophthalmology, University Hospital Taher Sfar, Mahdia, 5100, Tunisia
| | - Olfa Berriche
- Internal Medicine, University Hospital Taher Sfar, Mahdia, 5100, Tunisia
| | - Riadh Messaoud
- Ophthalmology, University Hospital Taher Sfar, Mahdia, 5100, Tunisia
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Ali F, Richardson RB. Electron, Photon, and Neutron Dose Conversion Coefficients of Lens and Non-Lens Tissues Using a Multi-Tissue Eye Model to Assess Risk of Cataracts and Retinitis. Radiat Res 2023; 200:162-175. [PMID: 37410087 DOI: 10.1667/rade-23-00023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/02/2023] [Indexed: 07/07/2023]
Abstract
Previous publications describe the estimation of the dose from ionizing radiation to the whole lens or parts of it but have not considered other eye tissues that are implicated in cataract development; this is especially critical for low-dose, low-ionizing-density exposures. A recent review of the biological mechanisms of radiation-induced cataracts showed that lenticular oxidative stress can be increased by inflammation and vascular damage to non-lens tissues in the eye. Also, the radiation oxygen effect indicates different radiosensitivities for the vascular retina and the severely hypoxic lens. Therefore, this study uses the Monte Carlo N-Particle simulations to quantify dose conversion coefficients for several eye tissues for incident antero-posterior exposure to electrons, photons, and neutrons (and the tertiary electron component of neutron exposure). A stylized, multi-tissue eye model was developed by modifying a model by Behrens etal. (2009) to include the retina, uvea, sclera, and lens epithelial cell populations. Electron exposures were simulated as a single eye, whereas photon and neutron exposures were simulated employing two eyes embedded in the ADAM-EVA phantom. For electrons and photons, dose conversion coefficients are highest for either anterior tissues for low-energy incident particles or posterior tissues for high-energy incident particles. Neutron dose conversion coefficients generally increase with increasing incident energy for all tissues. The ratio of the absorbed dose delivered to each tissue to the absorbed dose delivered to the whole lens demonstrated the considerable deviation of non-lens tissue doses from lens doses, depending on particle type and its energy. These simulations demonstrate that there are large variations in the dose to various ocular tissues depending on the incident radiation dose coefficients; this large variation will potentially impact cataract development.
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Affiliation(s)
- Fawaz Ali
- Canadian Nuclear Laboratories, Chalk River, Canada
| | - Richard B Richardson
- Canadian Nuclear Laboratories, Chalk River, Canada
- McGill University, Montreal, Canada
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4
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AlAmeer AM, Davis JB, Carey AR, Henderson AD. Outcomes of systemic bevacizumab in radiation-induced optic neuropathy, case series. J Neurooncol 2023:10.1007/s11060-023-04346-y. [PMID: 37227651 DOI: 10.1007/s11060-023-04346-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE Optic neuropathy is a rare, delayed complication after radiation with no universally accepted treatment modality. We report the outcomes of 6 patients with radiation-induced optic neuropathy (RION) who were treated with systemic bevacizumab. METHODS This is a retrospective series of 6 cases of RION, treated with intravenous (IV) bevacizumab. "Improved" or "worse" visual outcomes were defined as a change in best corrected visual acuity of ≥ 3 Snellen lines. Otherwise, the visual outcome was noted as "stable". RESULTS In our series, RION was diagnosed 8 to 36 months after radiotherapy. IV bevacizumab was initiated as treatment within 6 weeks of the onset of visual symptoms in 3 cases and after 3 months in the other cases. Although no improvement in visual function was observed, stabilization of vision was noted in 4 of the 6 cases. In the other 2 cases, the level of vision declined from counting fingers to no light perception. In 2 cases, bevacizumab treatment was discontinued prior to completion of the planned course due to renal stone formation or worsening of renal disease. One patient developed ischemic stroke 4 months after bevacizumab completion. CONCLUSION Systemic bevacizumab may stabilize vision in some patients with RION, though the limitations of our study do not allow us to draw this conclusion definitively. Therefore, the risks and potential benefits of using IV bevacizumab should be considered in each individual case.
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Affiliation(s)
- Ahmad Mohammed AlAmeer
- Division of Neuro-Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA.
- Division of Ophthalmology, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
| | - James Brian Davis
- Division of Neuro-Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Andrew Rising Carey
- Division of Neuro-Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Amanda Dean Henderson
- Division of Neuro-Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA
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Carey AR. Case Report: Successful treatment of external beam radiation-induced optic papillopathy with intravitreal anti-VEGF. FRONTIERS IN OPHTHALMOLOGY 2023; 3:1144241. [PMID: 38983066 PMCID: PMC11182080 DOI: 10.3389/fopht.2023.1144241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/04/2023] [Indexed: 07/11/2024]
Abstract
Three cases of optic disc edema arising from radiation optic neuropathy isolated to the intra-ocular optic nerve following external beam radiation for head and neck squamous cell carcinoma are presented. A literature review of the etiology, presentation, and treatment is included for discussion, along with proposed diagnostic criteria.
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Affiliation(s)
- Andrew R Carey
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Imaging perfusion changes in oncological clinical applications by hyperspectral imaging: a literature review. Radiol Oncol 2022; 56:420-429. [PMID: 36503709 PMCID: PMC9784371 DOI: 10.2478/raon-2022-0051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hyperspectral imaging (HSI) is a promising imaging modality that uses visible light to obtain information about blood flow. It has the distinct advantage of being noncontact, nonionizing, and noninvasive without the need for a contrast agent. Among the many applications of HSI in the medical field are the detection of various types of tumors and the evaluation of their blood flow, as well as the healing processes of grafts and wounds. Since tumor perfusion is one of the critical factors in oncology, we assessed the value of HSI in quantifying perfusion changes during interventions in clinical oncology through a systematic review of the literature. MATERIALS AND METHODS The PubMed and Web of Science electronic databases were searched using the terms "hyperspectral imaging perfusion cancer" and "hyperspectral imaging resection cancer". The inclusion criterion was the use of HSI in clinical oncology, meaning that all animal, phantom, ex vivo, experimental, research and development, and purely methodological studies were excluded. RESULTS Twenty articles met the inclusion criteria. The anatomic locations of the neoplasms in the selected articles were as follows: kidneys (1 article), breasts (2 articles), eye (1 article), brain (4 articles), entire gastrointestinal (GI) tract (1 article), upper GI tract (5 articles), and lower GI tract (6 articles). CONCLUSIONS HSI is a potentially attractive imaging modality for clinical application in oncology, with assessment of mastectomy skin flap perfusion after reconstructive breast surgery and anastomotic perfusion during reconstruction of gastrointenstinal conduit as the most promising at present.
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Carey AR, Page BR, Miller N. Radiation-induced optic neuropathy: a review. Br J Ophthalmol 2022; 107:743-749. [DOI: 10.1136/bjo-2022-322854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
Radiation is a commonly used treatment modality for head and neck as well as CNS tumours, both benign and malignant. As newer oncology treatments such as immunotherapies allow for longer survival, complications from radiation therapy are becoming more common. Radiation-induced optic neuropathy is a feared complication due to rapid onset and potential for severe and bilateral vision loss. Careful monitoring of high-risk patients and early recognition are crucial for initiating treatment to prevent severe vision loss due to a narrow therapeutic window. This review discusses presentation, aetiology, recent advances in diagnosis using innovative MRI techniques and best practice treatment options based on the most recent evidence-based medicine.
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Early anti-VEGF treatment for radiation maculopathy and optic neuropathy: lessons learned. Eye (Lond) 2022; 37:866-874. [PMID: 35974178 PMCID: PMC10050069 DOI: 10.1038/s41433-022-02200-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/17/2022] [Accepted: 08/02/2022] [Indexed: 11/08/2022] Open
Abstract
Radiation therapy has saved both sight and life for eye cancer patients. The most common methods include ophthalmic plaque brachytherapy and external beam techniques. However, subsequent dose-dependent radiation vasculopathy invariably occurs within and around the targeted zone. In 2006, Finger discovered that periodic intravitreal anti-vascular endothelial growth factor (anti-VEGF) bevacizumab could reverse and suppress intraocular radiation vasculopathy. At first, it was administered at the onset of radiation-related vision loss. Though bevacizumab induced regression of macular oedema, retinal haemorrhages and cotton-wool infarcts, most patients were left with residual retinal damage, manifest as metamorphopsia and loss of vision. These results led to earlier and earlier anti-VEGF interventions: first after signs of progressive radiation retinopathy, and then for signs of radiation maculopathy, and finally for high-risk eyes with no clinical signs of retinopathy. Earlier initiation of intravitreal anti-VEGF therapy typically resulted in greater restoration and preservation of macular anatomy, reductions of retinal haemorrhages, resolution of cotton-wool spots and vision preservation. Recent research on optical coherence tomography angiography (OCT-A) has revealed that radiation vasculopathy occurs prior to clinical ophthalmic signs or symptoms. Therefore, it seemed reasonable to consider treating high-risk patients (considered certain to eventually develop radiation maculopathy) to prevent or delay vision loss. Herein, we describe the evolution of treatment for radiation maculopathy as well as recent research supporting anti-VEGF treatment of high-risk patients immediately following radiation to maximize vision outcomes.
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Richardson RB. The role of oxygen and the Goldilocks range in the development of cataracts induced by space radiation in US astronauts. Exp Eye Res 2022; 223:109192. [DOI: 10.1016/j.exer.2022.109192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/26/2022] [Accepted: 07/13/2022] [Indexed: 11/04/2022]
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Chen S, Li M, Sun J, Wang D, Weng C, Zeng Y, Li Y, Huo S, Huang X, Li S, Zou T, Xu H. Human Umbilical Cord Blood-Derived CD133+CD34+ Cells Protect Retinal Endothelial Cells and Ganglion Cells in X-Irradiated Rats through Angioprotective and Neurotrophic Factors. Front Cell Dev Biol 2022; 10:801302. [PMID: 35223834 PMCID: PMC8866877 DOI: 10.3389/fcell.2022.801302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Radiation retinopathy (RR) is a common complication following radiation therapy of globe, head, and neck malignancies, and is characterized by microangiopathy, neuroretinopathy, and the irreversible loss of visual function. To date, there is no effective treatment for RR. Stem cells have been clinically used to treat retinal degeneration. CD133+CD34+ cells from human umbilical cord blood (hUCB-CD133+CD34+ cells), a subpopulation of hematopoietic stem cells, were applied to determine their protective efficacy on irradiated rat retinas. After X-ray irradiation on the retinas, rats were intravitreally injected with hUCB-CD133+CD34+ cells. Transplantation of hUCB-CD133+CD34+ cells prevented retinal dysfunction 2 weeks post-operation and lasted at least 8 weeks. CD133+CD34+ cells were distributed along the retinal vessel and migrated to the ganglion cell layer. Moreover, grafted CD133+CD34+ cells reduced the apoptosis of endothelial and ganglion cells in irradiated rats and increased the number of survived CD31+ retinal endothelial cells and Brn3a+ ganglion cells at 2 and 4 weeks, respectively, post-operation. Co-culturing of CD133+CD34+ cells or supernatants with irradiated human retinal microvascular endothelial cells (hRECs) in vitro, confirmed that CD133+CD34+ cells ameliorated hREC apoptosis caused by irradiation. Mechanistically, we found that angioprotective mediators and neurotrophic factors were secreted by CD133+CD34+ cells, which might attenuate irradiation-induced injury of retinal endothelial cells and ganglion cells. hUCB-CD133+CD34+ cell transplantation, as a novel treatment, protects retinal endothelial and ganglion cells of X-irradiated rat retinas, possibly through angioprotective and neurotrophic factors.
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Affiliation(s)
- Siyu Chen
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Minghui Li
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Jianguo Sun
- Cancer Institute, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dan Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chuanhuang Weng
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Yuxiao Zeng
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Yijian Li
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Shujia Huo
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Xiaona Huang
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Shiying Li
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
| | - Ting Zou
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
- *Correspondence: Ting Zou, ; Haiwei Xu,
| | - Haiwei Xu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration and Restoration of Chongqing, Chongqing, China
- *Correspondence: Ting Zou, ; Haiwei Xu,
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Marin L, Toumi E, Caujolle JP, Doyen J, Martel A, Nahon-Esteve S, Maschi C, Baillif S. OCT-angiography for the diagnosis of radiation maculopathy in patients treated with proton beam therapy: A 2-year prospective study. Eur J Ophthalmol 2021; 32:3035-3042. [PMID: 34894794 DOI: 10.1177/11206721211067331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Radiation maculopathy (RM) is the leading cause of visual acuity (VA) loss after proton beam therapy (PBT) of choroidal melanoma. The aim of this study was to assess the value of optical coherence tomography-angiography (OCT-A) for the diagnosis of RM in patients with choroidal melanoma treated with PBT. MATERIALS & METHODS This 2-year prospective, descriptive, single-center study included patients treated with PBT for choroidal melanoma. VA measurement, retinography, OCT and OCT-A were performed. Vascular density (VD) in the superficial capillary plexus (SCP), peri-foveal anastomotic ring changes and foveal avascular zone (FAZ) enlargement were studied. RESULTS Nineteen patients were included in the study. The median baseline melanoma thickness was 5.7 [3.6-8.1] mm. The median melanoma-to-macula distance was 3.5 [2.6-4.6] mm. The earliest signs of RM identified on retinography were hard exudates developing at 12 [12-24] months, followed by retinal hemorrhages at 18 [12-30] months, found in 88.9% and 77.8% of patients respectively. On OCT, the earliest sign was the onset/progression of cystoid macular edema (CME) at 12 [6-12] months, found in 10 patients (52.6%). On OCT-A, 100% of patients presented with a discontinuity of the perifoveal anastomotic ring and a FAZ enlargement after 12 [6-24] months. After 12 months, a VD loss in the SCP by 11.7% and 10.8% compared to baseline, was found in the macular and foveal areas respectively. A significant negative correlation was found between the VA and the VD in the macular SCP (R = -0.43; p = 0.029). CONCLUSION OCT-A is a reliable and effective diagnostic tool for RM in patients with choroidal melanoma treated with PBT.
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Affiliation(s)
- Louis Marin
- Service d'ophtalmologie, 37045Centre Hospitalier Universitaire de Nice, Nice, France
| | - Elsa Toumi
- Service d'ophtalmologie, 37045Centre Hospitalier Universitaire de Nice, Nice, France
| | - Jean-Pierre Caujolle
- Service d'ophtalmologie, 37045Centre Hospitalier Universitaire de Nice, Nice, France
| | - Jérôme Doyen
- Service de radiothérapie, 55121Centre Antoine Lacassagne, Nice, France
| | - Arnaud Martel
- Service d'ophtalmologie, 37045Centre Hospitalier Universitaire de Nice, Nice, France
| | - Sacha Nahon-Esteve
- Service d'ophtalmologie, 37045Centre Hospitalier Universitaire de Nice, Nice, France
| | - Célia Maschi
- Service d'ophtalmologie, 37045Centre Hospitalier Universitaire de Nice, Nice, France
| | - Stephanie Baillif
- Service d'ophtalmologie, 37045Centre Hospitalier Universitaire de Nice, Nice, France
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Abstract
Supplemental Digital Content is Available in the Text. Noninvasive retinal oximetry demonstrates alterations in eyes with untreated choroidal melanoma, including an increased difference between arterial and venous saturation. These changes were not observed in eyes with choroidal nevi and may be related to the tumour's metabolism or inflammatory changes. Purpose: To compare retinal vessel oxygenation in eyes with an untreated choroidal nevus or choroidal melanoma. Methods: The affected and fellow eye of patients with an untreated choroidal nevus (n = 42) or choroidal melanoma (n = 45) were investigated using noninvasive retinal oximetry (Oxymap T1). Oxygen saturation of arterioles (ArtSat) and venules (VenSat) was determined, together with the arteriovenous difference (AV-difference). Results: In choroidal nevus patients, retinal oximetry did not differ between the affected and fellow eye: the mean ArtSat was 94.5% and 94.2% (P = 0.56), the VenSat was 60.5% and 61.3% (P = 0.35), and the AV-difference was 34.0% and 32.9% (P = 0.18), respectively. In choroidal melanoma patients, alterations were detected: the mean ArtSat was 94.8% and 93.2% (P = 0.006), the VenSat was 58.0% and 60.0% (P = 0.014), and the AV-difference was 36.8% and 33.2% (P < 0.001), respectively. The largest increase in AV-difference was observed between the retinal halves without the lesion in melanoma eyes compared with the corresponding half in the fellow eye (37.5% vs. 32.1%, P < 0.001). Conclusion: Although retinal oximetry was not significantly altered in eyes with a choroidal nevus, eyes with choroidal melanoma showed an increased ArtSat and decreased VenSat, leading to an increased AV-difference. These changes may be caused by inflammation and a higher metabolism, with larger oxygen consumption, leading to altered blood flow and intraocular oxygen relocation.
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Abstract
Similar to other organs, the retina relies on tightly regulated perfusion and oxygenation. Previous studies have demonstrated that retinal blood flow is affected in a variety of eye and systemic diseases, including diabetic retinopathy, age-related macular degeneration, and glaucoma. Although measurement of peripheral oxygen saturation has become a standard clinical measurement through the development of pulse oximetry, developing a noninvasive technique to measure retinal oxygen saturation has proven challenging, and retinal oximetry technology currently remains inadequate for reliable clinical use. Here, we review current strategies and approaches, as well as several newer technologies in development, and discuss the future of retinal oximetry.
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Affiliation(s)
- Anupam K Garg
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.,School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Darren Knight
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Leonardo Lando
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Daniel L Chao
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.,School of Medicine, University of California San Diego, La Jolla, CA, USA.,Janssen Research and Development, Raritan, NJ, USA
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14
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Li Z, Zhan Z, Xiao J, Lan Y. Radiation-Induced Optical Coherence Tomography Angiography Retinal Alterations in Patients With Nasopharyngeal Carcinoma. Front Med (Lausanne) 2021; 7:630880. [PMID: 33614678 PMCID: PMC7886685 DOI: 10.3389/fmed.2020.630880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/23/2020] [Indexed: 11/13/2022] Open
Abstract
Aim: The aim of the study was to investigate the early neurovascular alterations of the retina in radiation encephalopathy (RE) patients with normal-ranged visual acuity after radiotherapy for nasopharyngeal carcinoma. Methods: Fifty-five RE patients and 54 healthy age-matched subjects were enrolled in this retrospective cross-sectional case–control study. The best corrected visual acuity (LogMAR) of the included eye should not be more than 0. The vessel density and thickness of different locations in the retina were acquired automatically using optical coherence tomography angiography (OCTA). The data were then compared between the RE patients and the controls. The location included the whole retina, the superficial vascular plexus (SVP)/the ganglion cell complex (GCC), the deep vascular plexus (DVP), and the choroid in the macular area, as well as the inside disc and peripapillary area in the optic nerve head (ONH). The risk factors in OCTA retinal impairments were analyzed using a backward multiple linear regression. The relationships between mean deviation (MD) and pattern standard deviation (PSD) in the visual field (VF) and the OCTA parameters were also analyzed in RE patients. Results: The vessel density of the GCC was significantly reduced in RE patients compared with controls (p = 0.018), and the reductions were mainly shown in the parafoveal (p = 0.049) and perifoveal fields (p = 0.006). The thickness of the GCC was correspondingly reduced (whole image GCC mean thickness: p = 0.044; parafoveal thickness: p = 0.038; perifoveal thickness: p = 0.038). In addition, the sub-foveal choroidal thickness (p = 0.039) was also reduced in RE patients. The vessel density of the GCC (R2 = 0.643) and DVP (R2 = 0.777) had a significant positive correlation with high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (ApoA1) and had a significant negative correlation with age (GCC: HDL-C, β = 29.89, p = 0.005; ApoA1, β = 78.92, p = 0.002; age, β = −0.886, p = 0.001; DVP: HDL-C, β = 40.09, p = 0.003; ApoA1, β = 62.65, p = 0.013; age, β = −1.31, p = 0.001). The vessel density of the GCC also had a significant negative correlation with apolipoprotein B (ApoB) (β = −32.18, p = 0.006). In the VF, MD had a significant positive correlation with the vessel density inside disc (R2 = 0.241, β = 0.304, p = 0.045), whereas PSD showed a significant negative correlation with the vessel density inside disc and the average GCC thickness, respectively (R2 = 0.437; vessel density inside disc, β = −0.358, p = 0.004; average GCC thickness, β = −0.510, p < 0.001). Conclusion: With the aid of OCTA, we found that neurovascular alterations of the retina may exist in RE patients with normal-ranged visual acuity. Herein, we suggest the implementation of OCTA to assist ophthalmologists in the early detection and consistent monitoring of radiation-related eye diseases to avoid delayed diagnosis.
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Affiliation(s)
- Zijing Li
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zongyi Zhan
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianhui Xiao
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuqing Lan
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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15
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Richardson RB, Ainsbury EA, Prescott CR, Lovicu FJ. Etiology of posterior subcapsular cataracts based on a review of risk factors including aging, diabetes, and ionizing radiation. Int J Radiat Biol 2020; 96:1339-1361. [DOI: 10.1080/09553002.2020.1812759] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Richard B. Richardson
- Radiobiology and Health Branch, Canadian Nuclear Laboratories (CNL), Chalk River, Canada
- McGill University’s Medical Physics Unit, Cedars Cancer Centre, Montreal, Canada
| | - Elizabeth A. Ainsbury
- Public Health England’s Centre for Chemical, Radiological and Environmental Hazards, Oxford, UK
| | | | - Frank J. Lovicu
- School of Medical Sciences, The University of Sydney, Sydney, Australia
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16
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Lemmens S, Van Eijgen J, Van Keer K, Jacob J, Moylett S, De Groef L, Vancraenendonck T, De Boever P, Stalmans I. Hyperspectral Imaging and the Retina: Worth the Wave? Transl Vis Sci Technol 2020; 9:9. [PMID: 32879765 PMCID: PMC7442879 DOI: 10.1167/tvst.9.9.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 06/23/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose Hyperspectral imaging is gaining attention in the biomedical field because it generates additional spectral information to study physiological and clinical processes. Several technologies have been described; however an independent, systematic literature overview is lacking, especially in the field of ophthalmology. This investigation is the first to systematically overview scientific literature specifically regarding retinal hyperspectral imaging. Methods A systematic literature review was conducted, in accordance with PRISMA Statement 2009 criteria, in four bibliographic databases: Medline, Embase, Cochrane Database of Systematic Reviews, and Web of Science. Results Fifty-six articles were found that meet the review criteria. A range of techniques was reported: Fourier analysis, liquid crystal tunable filters, tunable laser sources, dual-slit monochromators, dispersive prisms and gratings, computed tomography, fiber optics, and Fabry-Perrot cavity filter covered complementary metal oxide semiconductor. We present a narrative synthesis and summary tables of findings of the included articles, because methodologic heterogeneity and diverse research topics prevented a meta-analysis being conducted. Conclusions Application in ophthalmology is still in its infancy. Most previous experiments have been performed in the field of retinal oximetry, providing valuable information in the diagnosis and monitoring of various ocular diseases. To date, none of these applications have graduated to clinical practice owing to the lack of sufficiently large validation studies. Translational Relevance Given the promising results that smaller studies show for hyperspectral imaging (e.g., in Alzheimer's disease), advanced research in larger validation studies is warranted to determine its true clinical potential.
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Affiliation(s)
- Sophie Lemmens
- University Hospitals UZ Leuven, Department of Ophthalmology, Leuven, Belgium.,KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium.,VITO (Flemish Institute for Technological Research), Health Unit, Boeretang, Belgium
| | - Jan Van Eijgen
- University Hospitals UZ Leuven, Department of Ophthalmology, Leuven, Belgium.,KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium.,VITO (Flemish Institute for Technological Research), Health Unit, Boeretang, Belgium
| | - Karel Van Keer
- University Hospitals UZ Leuven, Department of Ophthalmology, Leuven, Belgium.,KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium
| | - Julie Jacob
- University Hospitals UZ Leuven, Department of Ophthalmology, Leuven, Belgium.,KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium
| | - Sinéad Moylett
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Lies De Groef
- Neural Circuit Development and Regeneration Research Group, Department of Biology, KU Leuven, Leuven, Belgium
| | - Toon Vancraenendonck
- VITO (Flemish Institute for Technological Research), Health Unit, Boeretang, Belgium
| | - Patrick De Boever
- VITO (Flemish Institute for Technological Research), Health Unit, Boeretang, Belgium.,Hasselt University, Centre of Environmental Sciences, Agoralaan, Belgium
| | - Ingeborg Stalmans
- University Hospitals UZ Leuven, Department of Ophthalmology, Leuven, Belgium.,KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium
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17
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Loganovsky KN, Marazziti D, Fedirko PA, Kuts KV, Antypchuk KY, Perchuk IV, Babenko TF, Loganovska TK, Kolosynska OO, Kreinis GY, Gresko MV, Masiuk SV, Mucci F, Zdorenko LL, Della Vecchia A, Zdanevich NA, Garkava NA, Dorichevska RY, Vasilenko ZL, Kravchenko VI, Drosdova NV. Radiation-Induced Cerebro-Ophthalmic Effects in Humans. Life (Basel) 2020; 10:E41. [PMID: 32316206 PMCID: PMC7235763 DOI: 10.3390/life10040041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/08/2020] [Accepted: 04/12/2020] [Indexed: 12/15/2022] Open
Abstract
Exposure to ionizing radiation (IR) could affect the human brain and eyes leading to both cognitive and visual impairments. The aim of this paper was to review and analyze the current literature, and to comment on the ensuing findings in the light of our personal contributions in this field. The review was carried out according to the PRISMA guidelines by searching PubMed, Scopus, Embase, PsycINFO and Google Scholar English papers published from January 2000 to January 2020. The results showed that prenatally or childhood-exposed individuals are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. In adulthood and medical/interventional radiologists, the most frequent IR-induced ophthalmic effects include cataracts, glaucoma, optic neuropathy, retinopathy and angiopathy, sometimes associated with specific neurocognitive deficits. According to available information that eye alterations may induce or may be associated with brain dysfunctions and vice versa, we propose to label this relationship "eye-brain axis", as well as to deepen the diagnosis of eye pathologies as early and easily obtainable markers of possible low dose IR-induced brain damage.
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Affiliation(s)
- Konstantin N. Loganovsky
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100 Pisa, Italy; (F.M.); (A.D.V.)
| | - Pavlo A. Fedirko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Kostiantyn V. Kuts
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Katerina Y. Antypchuk
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Iryna V. Perchuk
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Tetyana F. Babenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Tetyana K. Loganovska
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Olena O. Kolosynska
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - George Y. Kreinis
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Marina V. Gresko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Sergii V. Masiuk
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Federico Mucci
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100 Pisa, Italy; (F.M.); (A.D.V.)
- Dipartimento di Biochimica Biologia Molecolare, University of Siena, 53100 Siena, Italy
| | - Leonid L. Zdorenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Alessandra Della Vecchia
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100 Pisa, Italy; (F.M.); (A.D.V.)
| | - Natalia A. Zdanevich
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Natalia A. Garkava
- Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine, 9 Vernadsky Street, 49044 Dnipro, Ukraine;
| | - Raisa Y. Dorichevska
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Zlata L. Vasilenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Victor I. Kravchenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Nataliya V. Drosdova
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
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18
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Loganovsky KN, Fedirko PA, Kuts KV, Marazziti D, Antypchuk KY, Perchuk IV, Babenko TF, Loganovska TK, Kolosynska OO, Kreinis GY, Gresko MV, Masiuk SV, Zdorenko LL, Zdanevich NA, Garkava NA, Dorichevska RY, Vasilenko ZL, Kravchenko VI, Drosdova NV, Yefimova YV. BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. Part І. THE CONSEQUENCES OF IRRADIATION OF THE PARTICIPANTS OF THE LIQUIDATION OF THE CHORNOBYL ACCIDENT. PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2020; 25:90-129. [PMID: 33361831 DOI: 10.33145/2304-8336-2020-25-90-129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Exposure to ionizing radiation could affect the brain and eyes leading to cognitive and vision impairment, behavior disorders and performance decrement during professional irradiation at medical radiology, includinginterventional radiological procedures, long-term space flights, and radiation accidents. OBJECTIVE The objective was to analyze the current experimental, epidemiological, and clinical data on the radiation cerebro-ophthalmic effects. MATERIALS AND METHODS In our analytical review peer-reviewed publications via the bibliographic and scientometric bases PubMed / MEDLINE, Scopus, Web of Science, and selected papers from the library catalog of NRCRM - theleading institution in the field of studying the medical effects of ionizing radiation - were used. RESULTS The probable radiation-induced cerebro-ophthalmic effects in human adults comprise radiation cataracts,radiation glaucoma, radiation-induced optic neuropathy, retinopathies, angiopathies as well as specific neurocognitive deficit in the various neuropsychiatric pathology including cerebrovascular pathology and neurodegenerativediseases. Specific attention is paid to the likely stochastic nature of many of those effects. Those prenatally and inchildhood exposed are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. CONCLUSIONS The experimental, clinical, epidemiological, anatomical and pathophysiological rationale for visualsystem and central nervous system (CNS) radiosensitivity is given. The necessity for further international studieswith adequate dosimetric support and the follow-up medical and biophysical monitoring of high radiation riskcohorts is justified. The first part of the study currently being published presents the results of the study of theeffects of irradiation in the participants of emergency works at the Chornobyl Nuclear Power Plant (ChNPP).
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Affiliation(s)
- K N Loganovsky
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - P A Fedirko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - K V Kuts
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - D Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100, Pisa, Italy
| | - K Yu Antypchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - I V Perchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - T F Babenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - T K Loganovska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - O O Kolosynska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - G Yu Kreinis
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - M V Gresko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - S V Masiuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - L L Zdorenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N A Zdanevich
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N A Garkava
- State Institution «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», 9 Vernadsky Street, Dnipro, 49044, Ukraine
| | - R Yu Dorichevska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - Z L Vasilenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - V I Kravchenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N V Drosdova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - Yu V Yefimova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
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19
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Abstract
Innovations in ophthalmic imaging have made a profound impact on the diagnosis and treatment of ophthalmic disease. In ocular oncology, the development of optical coherence tomography with enhanced depth imaging and swept source technologies has made it possible to visualize the anatomical characteristics of retinoblastoma and uveal melanoma with a level of detail previously unobtainable on clinical exam alone. As a result, our understanding of the pathophysiology of vision loss in choroidal melanoma in particular has improved. These modalities have also helped identify fundoscopically “invisible” tumors and risk stratify pre-malignant choroidal lesions, making a strong case for their inclusion in all screening evaluations. Optical coherence tomography angiography, on the other hand, has allowed non-invasive imaging of the retinal and uveal vasculatures, providing insight into vascular changes associated with malignant transformation and vision loss following exposure to radiation. While the impact of new imaging technologies on clinical outcomes and overall survival in ocular oncology has yet to be determined, several reports cited herein offer promising results.
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Affiliation(s)
- Jose R Davila
- Ophthalmology, Stanford Byers Eye Institute, Palo Alto, CA, 94303, USA
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