Early detection of radiation retinopathy in pediatric patients undergoing external beam radiation using optical coherence tomography angiography

BACKGROUND AND OBJECTIVE: Detection of early vascular changes observed on optical coherence tomography angiography (OCTA) in children who have received external beam radiation and are at risk of developing radiation retinopathy (RR). PATIENTS AND METHODS: Eleven pediatric patients (20 eyes) with history of irradiation and nine healthy subjects (14 eyes) were retrospectively studied after dilated fundus exam and imaging. RESULTS: Four eyes of three patients had clinical RR. Eyes with radiation exposure but no RR had worse vision (no RR: logMAR 0.09 ± 0.14, Snellen 20/25) than controls (logMAR 0.01 ± 0.03, Snellen 20/21; P = .04) and increased superficial foveal avascular zone (FAZ) area (radiation: 0.31 ± 0.15 vs. control: 0.18 ± 0.10; P = .005). Eyes with RR had worse vision (RR: logMAR 0.34 ± 0.31, Snellen 20/44) than eyes with no RR (P = .001) and had increased deep FAZ (RR: 1.23 ± 0.40 vs. no RR: 0.68 ± 0.25; P = .01), but similar superficial FAZ (RR: 0.44 ± 0.28 vs. no RR: 0.31 ± 0.15; P = .42). CONCLUSIONS: Eyes with mildly decreased vision but no RR show superficial but not deep plexus changes. Eyes with RR have both superficial and deep plexus changes.