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Master Thesis

Évaluation des signes précoces cliniques et tomographiques de la maculopathie radique en OCT-A

Abstract : Purpose: radiation maculopathy is the main cause of loss of visual acuity secondary to proton beam therapy for choroidal melanoma. Optical coherence tomography angiography analyses with details central retinal lesions. This study aims to evaluate of the clinical and anatomical modifications of the macular microvascular meshwork among patients treated by proton beam therapy for uveal melanomas.
Materials and methods: we realized a prospective, descriptive and monocentric study with thirty-nine patients treated by proton beam in « l’Institut Mediterraneen de Protontherapie de Nice ». Each patient had a full ophthalmologic exam, including visual acuity, color retinophotography, optic coherence tomography and optic coherence tomography angiography. We studied the decrease of density and nonperfusion of superficial plexus’s capillaries as well as peri-foveal anastomotic circle’s modifications and avascular central zone’s enlargement.
Results: nineteen patients were included. Each patient developed radiation maculopathy with a median delay of twelve months. Increased or apparition of a cystoid macular edema was the earliest sign but with a poor sensibility (52.6%). Peri-foveal anastomotic circle ‘s discontinuity and avascular centrale zone’s enlargement appeared in 100% of patients in a median delay of twelve months. Significant negative correlation existed between visual acuity in LogMAR and macular superficial plexus’s vascular density (R= -0.43; p=0.029), with a mean loss of 11.7% at twelve months in comparation with control group.
Conclusion: our work is the first prospective study evaluating anatomical lesions of macular capillaries plexus with optic coherence tomography angiography. OCT-A is a reliable tool for the radiation maculopathy’s screening in patients with choroidal melanoma handled by proton beam therapy.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03020124
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Monday, November 23, 2020 - 4:59:08 PM
Last modification on : Tuesday, June 8, 2021 - 3:30:16 PM

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  • HAL Id : dumas-03020124, version 1

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Louis Marin. Évaluation des signes précoces cliniques et tomographiques de la maculopathie radique en OCT-A. Médecine humaine et pathologie. 2020. ⟨dumas-03020124⟩

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