Update on diagnosis and management of radiation retinopathy

Current Opinion in Ophthalmology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 10, 2025

Radiation retinopathy is a vision-threatening complication of radiotherapy involving the eye or surrounding structures. This review aims to summarize recent advances in understanding incidence, risk factors, pathophysiology, and utilization new diagnostic imaging tools for radiation retinopathy. It will also focus on current prophylaxis approaches prevent delay development radiation-related side effects treatment strategies once occurs. The incidence influenced by dose, fractionation schedule, patient-specific factors such as diabetes mellitus hypertension. Advances techniques, including optical coherence tomography angiography (OCTA) ultra-widefield fluorescein (UWFA), have enhanced early detection identifying subclinical retinal changes. Novel insights into pathophysiology suggest role endothelial damage, inflammation, oxidative stress disease progression. Prophylactic approaches, intravitreal antivascular growth factor (anti-VEGF) agents, shown promise reducing onset high-risk patients. Therapeutic options, anti-VEGF corticosteroids, demonstrated efficacy managing macular edema preserving vision. However, outcomes remain variable, necessitating personalized strategies. To address some these unanswered questions, Diabetic Retinopathy Clinical Research Network (DRCR) Protocol AL currently enrolling patients preparing analyze long-term treating prophylactically with faricimab 0.19 mg fluocinolone acetonide implant compared observation, identify which benefit from specific regimen, therefore moving towards approach this condition well. remains significant challenge ophthalmology. Early recognition through advanced tailored interventions, treatment, are crucial optimizing visual outcomes. Further research underlying mechanisms novel therapies essential reduce burden improve patient quality life.

Language: Английский

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Radiation Retinopathy: Microangiopathy-Inflammation-Neurodegeneration

Cells, Journal Year: 2025, Volume and Issue: 14(4), P. 298 - 298

Published: Feb. 18, 2025

Proton irradiation is used to treat choroidal melanoma of the eye. The impact on non-malignant retinal cells currently understudied. Therefore, we here report a mouse model investigate proton retina. We performed beam 5-15 Cobalt-Gray-Equivalent (CGE) eyes female C57Bl6/J (Cx3cr1+/+), Cx3cr1gfp/+ and Cx3cr1gfp/gfp mice mimicking clinical situation evaluated structure, function cellular composition retina up 24 weeks after irradiation. eye with 15 CGE leads cataract formation without affecting gross anatomy vasculature as shown by Fundus imaging in all genotypes respectively. However, 10 CGE, lead significant decrease NG2 positive cell numbers three dosages induced an increase GFAP immunoreactivity. At dosage resulted functional impairment both WT Cx3cr1 animals. Iba1 immunoreactivity was increased genotypes. animals invasion into deep vascular layer partially prevented. This accompanied less severe irradiated vs. WT. Although does not seem be affected irradiation, changed significantly reflecting situation. Moreover, one major long-term effects conclude that murine (WT genotype) can proton-beam associated side vivo well test prospective interventions. loss seems protective.

Language: Английский

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Transient Retinal Vessel Whitening After Whole-Ventricle Radiotherapy

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 6, 2025

We report a case of transient peripheral retinal vessel whitening following whole-ventricle radiotherapy in pediatric patient, which resolved spontaneously without signs ischemia. An 11-year-old girl with pituitary germinoma underwent chemotherapy and (23.4 Gy 13 fractions). At two months post-treatment, ultra-widefield scanning laser ophthalmoscopy revealed bilateral whitening, raising suspicion nonperfusion areas. However, optical coherence tomography angiography (OCTA) confirmed preserved blood flow Visual field testing did not reveal any abnormalities. No intervention was performed, the within months. Unlike typical radiation retinopathy, this represents reversible, non-ischemic process, could be attributed to limited exposure received during vascular plasticity young patients. Given that retinopathy is generally considered uncommon below 45 Gy, presents characteristic change occurring at lower doses underscores importance evaluation even low-dose irradiation settings. Non-invasive imaging techniques, such as OCTA ophthalmoscopy, can valuable for monitoring subtle radiation-induced changes. Further research needed refine screening management strategies effects.

Language: Английский

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Radiation-Induced Brain Injury with Special Reference to Astrocytes as a Therapeutic Target

Journal of Integrative Neuroscience, Journal Year: 2025, Volume and Issue: 24(3)

Published: March 21, 2025

Radiotherapy is one of the primary modalities for oncologic treatment and has been utilized at least once in over half newly diagnosed cancer patients. Cranial radiotherapy significantly enhanced long-term survival rates patients with brain tumors. However, radiation-induced injury, particularly hippocampal neuronal damage along impairment neurogenesis, inflammation, gliosis, adversely affects quality life these Astrocytes, a type glial cell that are abundant brain, play essential roles maintaining homeostasis function. Despite their importance, pathophysiological changes astrocytes induced by radiation have not thoroughly investigated, no systematic or comprehensive review addressing effects on related diseases conducted. In this paper, we current studies neurophysiological following exposure. We describe astrocytes, including astrogliosis, astrosenescence, associated cellular molecular mechanisms. Additionally, summarize impairments neurogenesis blood-brain barrier (BBB). Based research, propose may serve as potential therapeutic targets treating injury (RIBI) subsequent neurological neuropsychiatric disorders.

Language: Английский

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