| 脉络膜黑色素瘤局部放射治疗后黄斑部视网膜脉络膜血流变化的研究 |
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| 引用本文： | 王倩,杨婧研,刘月明,陈梦曦,魏文斌. 脉络膜黑色素瘤局部放射治疗后黄斑部视网膜脉络膜血流变化的研究[J]. 眼科, 2021, 30(2): 102-107. DOI: 10.13281/j.cnki.issn.1004-4469.2021.02.005 |
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| 作者姓名： | 王倩 杨婧研 刘月明 陈梦曦 魏文斌 |
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| 作者单位： | 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼内肿瘤诊治研究北京市重点实验室 眼科学与视觉科学北京市重点实验室 医学人工智能研究与验证工信部重点实验室100730 |
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| 基金项目： | 首都医科大学附属北京同仁医院种子基金项目(2017-YJJ-ZZL-009和2018-YJJ-ZZL-046);首都医科大学附属北京同仁医院拔尖人才培养计划;2018年度北京市优秀人才青年骨干个人;北京市属医院科研培育计划(PX2019008)。 |
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| 摘 要： | 目的 使用相干光断层扫描血流成像(OCTA)技术动态观察巩膜放射敷贴治疗前后脉络膜黑色素瘤患者黄斑区视网膜及脉络膜血流密度的变化情况,探索放射性视网膜病变(RR)发生前的眼部血流变化情况.设计前瞻性队列研究.研究对象2017年5月至2018年7月诊断为脉络膜黑色素瘤并进行碘125(125I)巩膜放射敷贴治疗的患者30例...
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| 关 键 词： | 放射性视网膜病变 相干光断层扫描血流成像 脉络膜黑色素瘤 |
| 收稿时间： | 2020-05-08 |
Longitudinal detection of radiation-induced macular retinal and choroidal capillary density changes with OCT angiography in choroidal melanoma |
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| Wang Qian,Yang Jingyan,Liu Yueming,Chen Mengxi,Wei Wenbin. Longitudinal detection of radiation-induced macular retinal and choroidal capillary density changes with OCT angiography in choroidal melanoma[J]. Ophthalmology in China, 2021, 30(2): 102-107. DOI: 10.13281/j.cnki.issn.1004-4469.2021.02.005 |
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| Authors: | Wang Qian Yang Jingyan Liu Yueming Chen Mengxi Wei Wenbin |
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| Affiliation: | Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China |
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| Abstract: | Objective To study longitudinal changes in retinal and choroidal capillary circulation in eyes treated with iodine 125(125I)plaque brachytherapy for uveal melanoma with OCT angiography(OCTA),and to explore changes in ocular blood flow before radiation retinopathy(RR).Design Prospective cohort study.Participants 30 patients diagnosed with choroidal melanoma from May 2017 to July 2018 and underwent 125I scleral radiotherapy.Methods Patients underwent OCTA examinations before 125I plaque brachytherapy,1 day,1 month,3 months,6 months and 12 months after the surgery.Retinal vascular density and choroidal capillary density were measured respectively and the correlation between visual acuity and OCTA parameters were analyzed.Main Outcome Measures Best corrected visual acuity(BCVA),retinal thickness,vacular density of the superficial and deep retinal in parafovea area,foveal avascular zone(FAZ)area,FD-300 area density,FD-300 length density and choroidal capillary vascular density.Results Before plaque brachytherapy,compared with the contralateral uninvolved eye,the choroidal melanoma eyes had thicker central macular thickness(P=0.004),lower parafoveal vascular density in superficial(P=0.05)and deep(P<0.001)retinal layer,smaller FAZ area(P=0.002),lower FD-300 area density(P<0.001),lower FD-300 length density(P=0.042),and lower choroidal capillary density(P=0.001).Patients were followed up for up to 12 months and found that FD-300 area density(P<0.001)and length density(P=0.007)gradually decreased.Although without statistically significant(all P>0.05),the superficial retinal vascular density gradually decreased with time,while the choroidal capillary vascular density increase at first and then decreased.Prior to scleral radiation application,the visual acuity of the affected eye was significantly correlated with the distance of the tumor from the optic disc(P=0.006)and macula(P=0.021).Multivariate linear regression analysis showed that 1 month after scleral radiation application,after adjusting the age and the distance of the tumor from the optic disc,the BCVA of the affected eye was significantly negatively correlated with central macular thickness.Conclusion Patients with choroidal melanoma had undergone changes in retinal and choroidal blood flow before receiving scleral radiotherapy,and the superficial retinal blood flow density gradually decreased as time passed after the plaque brachytherapy.It suggests that there may have been retinal vascular changes before the occurrence of radiation retinopathy.The retinal vascular changes existed before the occurrence of RR,which provides a new basis for the diagnosis and treatment timing of RR. |
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| Keywords: | radiation retinopathy optical coherence tomography angiography choroidal melanoma |
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