title: HYPERREFLECTIVE INTRARETINAL SPOTS IN RADIATION MACULAR EDEMA ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY.
abstract: OBJECTIVE
  To better pathophysiologically characterize macular edema secondary to eye irradiation, analyzing the presence of optical coherence tomography (OCT) hyperreflective spots.
  
  
  METHODS
  Twenty-five consecutive eyes affected by radiation maculopathy, secondary to irradiation for a primary uveal melanoma, without macular involvement in the irradiation field, were consecutively enrolled. All subjects underwent full ophthalmologic examination, including fluorescein angiography, color fundus photography, and spectral domain OCT, even in en face modality. Optical coherence tomography central subfield thickness was stratified into the following 3 categories: <400 μm, 400 to 600 μm, and >600 μm. Spectral domain OCT images were analyzed to measure and localize hyperreflective spots by two independent masked graders.
  
  
  RESULTS
  Hyperreflective spots were documented in all eyes (100%). Hyperreflective spots significantly increased in number according to OCT central subfield thickness (<400 μm, 400-600 μm, >600 μm, P < 0.05). The intergrader agreement was at least substantial for all measurements (intraclass correlation coefficient: 0.80).
  
  
  CONCLUSIONS
  Spectral domain OCT documents discrete intraretinal reflectivity changes (hyperreflective spots) in all (studied) eyes affected by radiation maculopathy. Hyperreflective spots increase in number with increasing central subfield thickness and could be considered as a new clinical biomarker of intraretinal inflammation in patients affected by macular edema secondary to irradiation for uveal melanoma.
authors.affiliation: *Department of Ophthalmology, University of Padova, Padova, Italy; †Ocular Oncology and Toxicology Research Unit, G.B. Bietti Foundation, IRCCS, Roma, Italy; and ‡University Campus Bio-Medico, Roma, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Frizziero
authors.forename: Raffaele
authors.initials: R
authors.lastname: Parrozzani
authors.forename: Giulia
authors.initials: G
authors.lastname: Midena
authors.forename: Giacomo
authors.initials: G
authors.lastname: Miglionico
authors.forename: Stela
authors.initials: S
authors.lastname: Vujosevic
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pilotto
authors.forename: Edoardo
authors.initials: E
authors.lastname: Midena
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008269:Macular Edema / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008545:Melanoma / Q000532:radiotherapy; D008875:Middle Aged; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D012160:Retina / Q000000981:diagnostic imaging / Q000528:radiation effects*; D041623:Tomography, Optical Coherence; D014604:Uveal Neoplasms / Q000532:radiotherapy; D014792:Visual Acuity; D000098943:Uveal Melanoma
chemical_list: D007457:Iodine Radioisotopes