NONINVASIVE GRADING OF RADIATION RETINOPATHY

In Brief Purpose: 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. Methods: 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. Results: 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,++,++,+). Conclusion: The use of OCT-A allows for earlier detection of RR; thus, existing grading systems should be modified to include OCT-A. Previous studies have shown that spectral domain optical coherence tomography can diagnose radiation retinopathy before ophthalmoscopic findings. Recently, optical coherence tomography angiography has been helpful in seeing vascular findings undetected by spectral domain optical coherence tomography. The authors demonstrate optical coherence tomography angiography findings at varying levels of radiation retinopathy and propose an updated grading system based on noninvasive imaging techniques.