Evaluation of Vascular Changes with Optical Coherence Tomography Angiography after Plaque Radiotherapy of Choroidal Melanoma

Ophthalmic Res. 2018;60(4):238-242. doi: 10.1159/000490571. Epub 2018 Aug 17.

Abstract

Aim: The purpose of this paper was to evaluate whether optical coherence tomography angiography (OCT-A) can be used to quantify the vascular changes in radiation maculopathy, and changes in the tumor vasculature in eyes treated with plaque radiotherapy for choroidal melanoma.

Methods: In this prospective study, we evaluated 39 Caucasian patients with choroidal melanoma (39 eyes) treated with ruthenium-106 plaque radiotherapy. The patients underwent complete ophthalmic examination, bulbar echography, and OCT-A before and 1 year after treatment.

Results: At baseline, the mean best-corrected visual acuity (BCVA) in the affected eyes was 0.35 ± 0.40 logMAR, and the mean tumor thickness was 2.68 ± 0.25 mm at A-scan echography. After treatment, the mean BCVA increased to 0.41 logMAR, the mean tumor thickness decreased to 1.66 ± 0.23 mm, and the tumor basal diameter was significantly reduced (U = 108, p = 0.001). Moreover, the capillary vessel density was significantly lower in all Early Treatment of Diabetic Retinopathy Study sectors, and both the vessel and flow areas were significantly reduced (p = 0.030 and p = 0.001, respectively).

Conclusions: OCT-A is a noninvasive, reliable method with which to quantify the vessel changes in radiation maculopathy and, given the association between vascularization and malignancy, this procedure may be an aid in treatment decision-making and in monitoring the efficacy of treatment.

Keywords: Choroidal melanoma; Optical coherence tomography angiography; Radiotherapy.

MeSH terms

  • Brachytherapy / methods*
  • Choroid / blood supply*
  • Choroid / radiation effects
  • Choroid Neoplasms / blood supply*
  • Choroid Neoplasms / radiotherapy
  • Female
  • Fluorescein Angiography / methods*
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Male
  • Melanoma / blood supply*
  • Melanoma / radiotherapy
  • Middle Aged
  • Prospective Studies
  • Retinal Vessels / diagnostic imaging*
  • Retinal Vessels / radiation effects
  • Tomography, Optical Coherence / methods*