Quantitative OCT Angiography Evaluation of Peripapillary Retinal Circulation after Plaque Brachytherapy

Alison Skalet, Liang Liu, Christina Binder, Audra K. Miller, Jie Wang, David J. Wilson, Richard Crilly, Charles R. Thomas, Arthur Y. Hung, David Huang, Jia Yali

Research output: Contribution to journalArticle

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Abstract

Purpose: To study peripapillary retinal capillary circulation in eyes treated with iodine 125 (I125) plaque brachytherapy for uveal melanoma using optical coherence tomography angiography (OCTA). Design: Cross-sectional study of 10 participants imaged with OCTA before uveal melanoma treatment and 15 participants imaged after development of radiation retinopathy, optic neuropathy, or both. Participants: After institutional review board approval, participants were enrolled from an academic ocular oncology clinical practice. All participants had uveal melanoma in 1 eye, and treatment with I125 plaque brachytherapy was planned or had taken place previously. Patients with low vision at baseline and uncontrolled hypertension were excluded. In the posttreatment group, 7 participants were men and 8 were women; age range was 38 to 81 years. Visual acuities in the irradiated eyes ranged from 20/20 to counting fingers. Visual acuities in the untreated fellow eyes were 20/25 or better. Methods: Peripapillary retinal capillary circulation was measured by OCTA (Optovue, Inc). Optic disc scans measuring 4.5 × 4.5 mm were obtained. Main Outcome Measures: The relationship of the peripapillary retinal capillary density (PPCD) as measured by OCTA to the calculated dose to the optic nerve (the dose to 50% of the disc [D50]) and visual acuity in logarithm of the minimal angle of resolution units were evaluated. Results: No significant differences were observed in the PPCD as measured by OCTA when comparing the eye with melanoma with the fellow eye before brachytherapy; however, the PPCD was significantly lower in treated eyes (52.9% ± 22.4%) than in fellow eyes that did not receive radiation (73.3% ± 13.7%; P = 0.004). There was an inverse linear correlation between D50 and the PPCD (Pearson's r = −0.528; P = 0.043) and between visual acuity and the PPCD (Pearson's r = −0.564; P = 0.028). Conclusions: Among patients with clinically apparent radiation retinopathy, radiation optic neuropathy, or both, PPCD was lower in the treated eye and correlated with the radiation dose to the optic nerve and the visual acuity. Optical coherence tomography angiography provides a measure of capillary changes after radiation and may serve as a quantitative end point to address visual prognosis.

Original languageEnglish (US)
Pages (from-to)244-250
Number of pages7
JournalOphthalmology Retina
Volume2
Issue number3
DOIs
StatePublished - Mar 1 2018

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Brachytherapy
Angiography
Optical Coherence Tomography
Visual Acuity
Radiation
Optic Nerve Diseases
Optic Nerve
Iodine
Low Vision
Medical Oncology
Research Ethics Committees
Optic Disk
Fingers
Melanoma
Cross-Sectional Studies
Outcome Assessment (Health Care)
Hypertension

ASJC Scopus subject areas

  • Nephrology

Cite this

Quantitative OCT Angiography Evaluation of Peripapillary Retinal Circulation after Plaque Brachytherapy. / Skalet, Alison; Liu, Liang; Binder, Christina; Miller, Audra K.; Wang, Jie; Wilson, David J.; Crilly, Richard; Thomas, Charles R.; Hung, Arthur Y.; Huang, David; Yali, Jia.

In: Ophthalmology Retina, Vol. 2, No. 3, 01.03.2018, p. 244-250.

Research output: Contribution to journalArticle

Skalet, Alison ; Liu, Liang ; Binder, Christina ; Miller, Audra K. ; Wang, Jie ; Wilson, David J. ; Crilly, Richard ; Thomas, Charles R. ; Hung, Arthur Y. ; Huang, David ; Yali, Jia. / Quantitative OCT Angiography Evaluation of Peripapillary Retinal Circulation after Plaque Brachytherapy. In: Ophthalmology Retina. 2018 ; Vol. 2, No. 3. pp. 244-250.
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abstract = "Purpose: To study peripapillary retinal capillary circulation in eyes treated with iodine 125 (I125) plaque brachytherapy for uveal melanoma using optical coherence tomography angiography (OCTA). Design: Cross-sectional study of 10 participants imaged with OCTA before uveal melanoma treatment and 15 participants imaged after development of radiation retinopathy, optic neuropathy, or both. Participants: After institutional review board approval, participants were enrolled from an academic ocular oncology clinical practice. All participants had uveal melanoma in 1 eye, and treatment with I125 plaque brachytherapy was planned or had taken place previously. Patients with low vision at baseline and uncontrolled hypertension were excluded. In the posttreatment group, 7 participants were men and 8 were women; age range was 38 to 81 years. Visual acuities in the irradiated eyes ranged from 20/20 to counting fingers. Visual acuities in the untreated fellow eyes were 20/25 or better. Methods: Peripapillary retinal capillary circulation was measured by OCTA (Optovue, Inc). Optic disc scans measuring 4.5 × 4.5 mm were obtained. Main Outcome Measures: The relationship of the peripapillary retinal capillary density (PPCD) as measured by OCTA to the calculated dose to the optic nerve (the dose to 50{\%} of the disc [D50]) and visual acuity in logarithm of the minimal angle of resolution units were evaluated. Results: No significant differences were observed in the PPCD as measured by OCTA when comparing the eye with melanoma with the fellow eye before brachytherapy; however, the PPCD was significantly lower in treated eyes (52.9{\%} ± 22.4{\%}) than in fellow eyes that did not receive radiation (73.3{\%} ± 13.7{\%}; P = 0.004). There was an inverse linear correlation between D50 and the PPCD (Pearson's r = −0.528; P = 0.043) and between visual acuity and the PPCD (Pearson's r = −0.564; P = 0.028). Conclusions: Among patients with clinically apparent radiation retinopathy, radiation optic neuropathy, or both, PPCD was lower in the treated eye and correlated with the radiation dose to the optic nerve and the visual acuity. Optical coherence tomography angiography provides a measure of capillary changes after radiation and may serve as a quantitative end point to address visual prognosis.",
author = "Alison Skalet and Liang Liu and Christina Binder and Miller, {Audra K.} and Jie Wang and Wilson, {David J.} and Richard Crilly and Thomas, {Charles R.} and Hung, {Arthur Y.} and David Huang and Jia Yali",
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AU - Skalet, Alison

AU - Liu, Liang

AU - Binder, Christina

AU - Miller, Audra K.

AU - Wang, Jie

AU - Wilson, David J.

AU - Crilly, Richard

AU - Thomas, Charles R.

AU - Hung, Arthur Y.

AU - Huang, David

AU - Yali, Jia

PY - 2018/3/1

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N2 - Purpose: To study peripapillary retinal capillary circulation in eyes treated with iodine 125 (I125) plaque brachytherapy for uveal melanoma using optical coherence tomography angiography (OCTA). Design: Cross-sectional study of 10 participants imaged with OCTA before uveal melanoma treatment and 15 participants imaged after development of radiation retinopathy, optic neuropathy, or both. Participants: After institutional review board approval, participants were enrolled from an academic ocular oncology clinical practice. All participants had uveal melanoma in 1 eye, and treatment with I125 plaque brachytherapy was planned or had taken place previously. Patients with low vision at baseline and uncontrolled hypertension were excluded. In the posttreatment group, 7 participants were men and 8 were women; age range was 38 to 81 years. Visual acuities in the irradiated eyes ranged from 20/20 to counting fingers. Visual acuities in the untreated fellow eyes were 20/25 or better. Methods: Peripapillary retinal capillary circulation was measured by OCTA (Optovue, Inc). Optic disc scans measuring 4.5 × 4.5 mm were obtained. Main Outcome Measures: The relationship of the peripapillary retinal capillary density (PPCD) as measured by OCTA to the calculated dose to the optic nerve (the dose to 50% of the disc [D50]) and visual acuity in logarithm of the minimal angle of resolution units were evaluated. Results: No significant differences were observed in the PPCD as measured by OCTA when comparing the eye with melanoma with the fellow eye before brachytherapy; however, the PPCD was significantly lower in treated eyes (52.9% ± 22.4%) than in fellow eyes that did not receive radiation (73.3% ± 13.7%; P = 0.004). There was an inverse linear correlation between D50 and the PPCD (Pearson's r = −0.528; P = 0.043) and between visual acuity and the PPCD (Pearson's r = −0.564; P = 0.028). Conclusions: Among patients with clinically apparent radiation retinopathy, radiation optic neuropathy, or both, PPCD was lower in the treated eye and correlated with the radiation dose to the optic nerve and the visual acuity. Optical coherence tomography angiography provides a measure of capillary changes after radiation and may serve as a quantitative end point to address visual prognosis.

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