NONINVASIVE GRADING OF RADIATION RETINOPATHY: The Use of Optical Coherence Tomography Angiography

• Published in: Retina (Philadelphia, Pa.) Vol. 35; no. 11; p. 2400
• Main Authors: Veverka, Kevin K, AbouChehade, Jackson E, Iezzi, Jr, Raymond, Pulido, Jose S
• Format: Journal Article
• Language: English
• Published: United States 01.11.2015
• Subjects: Adult; Aged; Brachytherapy - adverse effects; Choroid Neoplasms - radiotherapy; Female; Fluorescein Angiography; Humans; Iodine Radioisotopes; Male; Melanoma - radiotherapy; Middle Aged; Radiation Injuries - classification; Radiation Injuries - etiology; Radiation Injuries - pathology; Retina - radiation effects; Retinal Diseases - classification; Retinal Diseases - etiology; Retinal Diseases - pathology; Tomography, Optical Coherence
• ISSN: 1539-2864
• DOI: 10.1097/IAE.0000000000000844

Previous studies have shown that spectral domain optical coherence tomography can diagnose radiation retinopathy (RR) before ophthalmoscopic findings. Recently, optical coherence tomography angiography (OCT-A) has been helpful in seeing vascular findings undetected by spectral domain optical coherence tomography. The authors wish to demonstrate the OCT-A grading at varying levels of RR. The OCT-A, spectral domain optical coherence tomography, and ophthalmoscopic findings on 7 patients from December 2014 to March 2015 with varying levels of RR are demonstrated. Findings on OCT-A could be demonstrated before spectral domain optical coherence tomography findings. Patients can be graded on a scale of increasing severity from 0 to 5, based on positive or negative clinical findings of RR between OCT-A. Optical coherence tomography increased central macular thickness, optical coherence tomography evident cysts, and ophthalmoscopy (Grade 0: -,-,-,-; Grade 1: +,-,-,-; Grade 2: +,+,-,-; Grade 3: +,+,+,-; Grade 4: ++,+,+,+; Grade 5: unreadable,++,++,+). The use of OCT-A allows for earlier detection of RR; thus, existing grading systems should be modified to include OCT-A.