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Kinaci-Tas B, Alderliesten T, Verbraak FD, Rasch CRN. Radiation-Induced Retinopathy and Optic Neuropathy after Radiation Therapy for Brain, Head, and Neck Tumors: A Systematic Review. Cancers (Basel) 2023; 15:cancers15071999. [PMID: 37046660 PMCID: PMC10093581 DOI: 10.3390/cancers15071999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
Background: Patients with brain, head, and neck tumors experience a decline in their quality of life due to radiation retinopathy and optic neuropathy. Little is known about the dose–response relationship and patient characteristics. We aimed to systematically review the prevalence of radiation retinopathy and optic neuropathy. Method: The primary outcome was the pooled prevalence of radiation retinopathy and optic neuropathy. The secondary outcome included the effect of the total radiation dose prescribed for the tumor according to the patient’s characteristics. Furthermore, we aimed to evaluate the radiation dose parameters for organs at risk of radiation retinopathy and optic neuropathy. Results: The pooled prevalence was 3.8%. No retinopathy was reported for the tumor’s prescribed dose of <50 Gy. Optic neuropathy was more prevalent for a prescribed dose of >50 Gy than <50 Gy. We observed a higher prevalence rate for retinopathy (6.0%) than optic neuropathy (2.0%). Insufficient data on the dose for organs at risk were reported. Conclusion: The prevalence of radiation retinopathy was higher compared to optic neuropathy. This review emphasizes the need for future studies considering retinopathy and optic neuropathy as primary objective parameters.
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Affiliation(s)
- Buket Kinaci-Tas
- Department of Radiation Oncology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
- Correspondence:
| | - Tanja Alderliesten
- Department of Radiation Oncology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
| | - Frank D. Verbraak
- Department of Ophthalmology, Amsterdam University Medical Centers, Location VU Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Coen R. N. Rasch
- Department of Radiation Oncology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
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Huang YT, Wang I, Lin CJ, Lai CT, Hsia NY, Chen HS, Tien PT, Bair H, Lin JM, Chen WL, Chen CH, Wu WC, Tsai YY. Comparison of Choroidal Thickness, Foveal Avascular Zone, and Macular Capillary Density in Macular Edema Secondary to Branch Retinal Vein Occlusion Treated with Ranibizumab or Aflibercept-A Prospective Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58040540. [PMID: 35454378 PMCID: PMC9031043 DOI: 10.3390/medicina58040540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 11/16/2022]
Abstract
This prospective comparative case series aims to compare best-corrected visual acuity (BCVA), retinal microvasculature, and retinal structural changes in patients treated with either ranibizumab or aflibercept for macular edema (ME) secondary to treatment-naïve branch retinal vein occlusion (BRVO) by optical coherence tomography angiography (OCTA). Ten patients were enrolled with macular capillary density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and foveal avascular zone (FAZ) measured in both eyes before and after treatment. Final central retinal thickness and BCVA improved significantly (p < 0.05), and densities of SCP and DCP of BRVO sectors were significantly lower at baseline than fellow eye counterparts and remained persistently lower during treatment, particularly in the aflibercept group (p < 0.05). SCP density, DCP density of both BRVO sectors (p = 0.0001, p < 0.0001), and non-BRVO sectors (p < 0.0001, p < 0.0001) were significantly correlated with final BCVA for diseased eyes. Using multivariate general linear model analysis, and including OCTA parameters only, but not all of the available clinical data, DCP density of BRVO sectors in both eyes was the most predictive factor for final visual outcome (probability p < 0.0001). OCTA offered further qualitative and quantitative evaluation of treatment-naïve BRVO. Judging by OCTA parameters, not only in the diseased eye but also in the fellow eye, DCP density of BRVO sectors was the most predictive factor of final visual outcome.
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Affiliation(s)
- Yu-Te Huang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
| | - I Wang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
- School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Optometry, Asia University, Taichung 413, Taiwan
- Correspondence: (C.-J.L.); (C.-T.L.); Tel.: +886-4-22052121 (ext. 1141) (C.-J.L.); Fax: 886-4-22059265 (C.-J.L.)
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
- Correspondence: (C.-J.L.); (C.-T.L.); Tel.: +886-4-22052121 (ext. 1141) (C.-J.L.); Fax: 886-4-22059265 (C.-J.L.)
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
| | - Huan-Sheng Chen
- An-Shin Dialysis Center, NephroCare Ltd., Fresenius Medical Care, Taichung 401, Taiwan;
| | - Peng-Tai Tien
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Henry Bair
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA 94303, USA;
| | - Jane-Ming Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
| | - Wen-Lu Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
| | - Chang-He Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
| | - Wen-Chuan Wu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (Y.-T.H.); (I.W.); (N.-Y.H.); (P.-T.T.); (J.-M.L.); (W.-L.C.); (C.-H.C.); (W.-C.W.); (Y.-Y.T.)
- School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Optometry, Asia University, Taichung 413, Taiwan
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Li Z, Zhan Z, Lai Y, Fang Q, Lan Y. Radiation optic neuropathy diagnosis in nasopharyngeal carcinoma patients with radiation encephalopathy. Eur J Ophthalmol 2022; 32:3657-3666. [PMID: 35285300 DOI: 10.1177/11206721221085834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To develop a suitable radiation optic neuropathy (RON) diagnostic model based on optical coherence tomography angiography (OCTA) and to reveal the correlation between endocrine and OCTA indexes in nasopharyngeal carcinoma (NPC) patients with radiation encephalopathy (RE). METHODS This retrospective cross-sectional study included seventy-seven male NPC patients with RE following radiotherapy (41 non-RON and 36 RON). Endocrine and OCTA indexes were collected. The macular and peripapillary vessel density (VD) were automatically analyzed using AngioVue 2.0 of the RTVue XR Avanti device. The OCTA indexes were included in the multivariable binary logistic regression model between non-RON and RON. For all RE patients, a multiple linear regression was performed between each of the OCTA indexes and the endocrine indexes. RESULTS Compared to non-RON, enlarged foveal avascular zone (FAZ) area, reduced superficial vascular plexus (SVP) VD and radial peripapillary capillary plexus density, reduced full retinal thickness, ganglion cell complex thickness and peripapillary retinal nerve fiber layer thickness were observed in RON. Foveal VD in the SVP was included in the RON diagnostic model. Free triiodothyronine (FT3) showed a significantly negative correlation with the FAZ area but showed a significantly positive correlation with foveal VD in the SVP and deep vascular plexus, peripapillary VD and thickness and parafoveal and perifoveal thickness. CONCLUSIONS OCTA may be useful for diagnosing RON in male NPC patients with RE following radiotherapy. Reduced FT3 and foveal VD in SVP may be sensitive in screening RON in these patients.
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Affiliation(s)
- Zijing Li
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zongyi Zhan
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yitao Lai
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Qianqi Fang
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yuqing Lan
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
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