{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T06:36:24Z","timestamp":1763015784148,"version":"3.41.2"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Aim:<\/jats:bold> The aim of the study was to investigate the early neurovascular alterations of the retina in radiation encephalopathy (RE) patients with normal-ranged visual acuity after radiotherapy for nasopharyngeal carcinoma.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Fifty-five RE patients and 54 healthy age-matched subjects were enrolled in this retrospective cross-sectional case\u2013control study. The best corrected visual acuity (LogMAR) of the included eye should not be more than 0. The vessel density and thickness of different locations in the retina were acquired automatically using optical coherence tomography angiography (OCTA). The data were then compared between the RE patients and the controls. The location included the whole retina, the superficial vascular plexus (SVP)\/the ganglion cell complex (GCC), the deep vascular plexus (DVP), and the choroid in the macular area, as well as the inside disc and peripapillary area in the optic nerve head (ONH). The risk factors in OCTA retinal impairments were analyzed using a backward multiple linear regression. The relationships between mean deviation (MD) and pattern standard deviation (PSD) in the visual field (VF) and the OCTA parameters were also analyzed in RE patients.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The vessel density of the GCC was significantly reduced in RE patients compared with controls (<jats:italic>p<\/jats:italic> = 0.018), and the reductions were mainly shown in the parafoveal (<jats:italic>p<\/jats:italic> = 0.049) and perifoveal fields (<jats:italic>p<\/jats:italic> = 0.006). The thickness of the GCC was correspondingly reduced (whole image GCC mean thickness: <jats:italic>p<\/jats:italic> = 0.044; parafoveal thickness: <jats:italic>p<\/jats:italic> = 0.038; perifoveal thickness: <jats:italic>p<\/jats:italic> = 0.038). In addition, the sub-foveal choroidal thickness (<jats:italic>p<\/jats:italic> = 0.039) was also reduced in RE patients. The vessel density of the GCC (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.643) and DVP (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.777) had a significant positive correlation with high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (ApoA1) and had a significant negative correlation with age (GCC: HDL-C, \u03b2 = 29.89, <jats:italic>p<\/jats:italic> = 0.005; ApoA1, \u03b2 = 78.92, <jats:italic>p<\/jats:italic> = 0.002; age, \u03b2 = \u22120.886, <jats:italic>p<\/jats:italic> = 0.001; DVP: HDL-C, \u03b2 = 40.09, <jats:italic>p<\/jats:italic> = 0.003; ApoA1, \u03b2 = 62.65, <jats:italic>p<\/jats:italic> = 0.013; age, \u03b2 = \u22121.31, <jats:italic>p<\/jats:italic> = 0.001). The vessel density of the GCC also had a significant negative correlation with apolipoprotein B (ApoB) (\u03b2 = \u221232.18, <jats:italic>p<\/jats:italic> = 0.006). In the VF, MD had a significant positive correlation with the vessel density inside disc (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.241, \u03b2 = 0.304, <jats:italic>p<\/jats:italic> = 0.045), whereas PSD showed a significant negative correlation with the vessel density inside disc and the average GCC thickness, respectively (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.437; vessel density inside disc, \u03b2 = \u22120.358, <jats:italic>p<\/jats:italic> = 0.004; average GCC thickness, \u03b2 = \u22120.510, <jats:italic>p<\/jats:italic> &amp;lt; 0.001).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> With the aid of OCTA, we found that neurovascular alterations of the retina may exist in RE patients with normal-ranged visual acuity. Herein, we suggest the implementation of OCTA to assist ophthalmologists in the early detection and consistent monitoring of radiation-related eye diseases to avoid delayed diagnosis.<\/jats:p>","DOI":"10.3389\/fmed.2020.630880","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T04:21:21Z","timestamp":1612326081000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Radiation-Induced Optical Coherence Tomography Angiography Retinal Alterations in Patients With Nasopharyngeal Carcinoma"],"prefix":"10.3389","volume":"7","author":[{"given":"Zijing","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zongyi","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhui","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqing","family":"Lan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"599","DOI":"10.3389\/fnins.2018.00599","article-title":"Cortical surface area rather than cortical thickness potentially differentiates radiation encephalopathy at early stage in patients with nasopharyngeal carcinoma","volume":"12","author":"Zhang","year":"2018","journal-title":"Front Neurosci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"114","DOI":"10.5732\/cjc.010.10377","article-title":"The prevalence and prevention of nasopharyngeal carcinoma in China","volume":"30","author":"Cao","year":"2011","journal-title":"Chin J Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1186\/1471-2407-13-397","article-title":"Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis","volume":"13","author":"Sun","year":"2013","journal-title":"BMC Cancer"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e67488","DOI":"10.1371\/journal.pone.0067488","article-title":"Radiation-induced temporal lobe injury for nasopharyngeal carcinoma: a comparison of intensity-modulated radiotherapy and conventional two-dimensional radiotherapy","volume":"8","author":"Zhou","year":"2013","journal-title":"PLoS ONE."},{"key":"B5","doi-asserted-by":"publisher","first-page":"715","DOI":"10.3892\/ol.2017.6199","article-title":"Dynamic MRI follow-up of radiation encephalopathy in the temporal lobe following nasopharyngeal carcinoma radiotherapy","volume":"14","author":"Zhou","year":"2017","journal-title":"Oncol Lett."},{"key":"B6","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1097\/WNO.0000000000000670","article-title":"Radiation-induced optic neuropathy: clinical and imaging profile of twelve patients","volume":"39","author":"Archer","year":"2019","journal-title":"J Neuroophthalmol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1097\/ICU.0000000000000141","volume":"26","year":"2015","journal-title":"Curr Opin Ophthalmol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3109\/15569520903331674","article-title":"High-resolution optical coherence tomography correlates in ischemic radiation retinopathy","volume":"29","author":"Raman","year":"2010","journal-title":"Cutan Ocul Toxicol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3928\/15428877-20111129-09","article-title":"Optical coherence tomography of radiation optic neuropathy","volume":"43","author":"Yousef","year":"2012","journal-title":"Ophthalmic Surg Lasers Imaging"},{"key":"B10","doi-asserted-by":"publisher","first-page":"446","DOI":"10.5301\/EJO.2011.6213","article-title":"Intravitreal anti-VEGF bevacizumab (Avastin) for external beam related radiation retinopathy","volume":"21","author":"Finger","year":"2011","journal-title":"Eur J Ophthalmol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1016\/S0161-6420(91)32165-1","article-title":"Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study","volume":"98","author":"Kwiterovich","year":"1991","journal-title":"Ophthalmology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/S1081-1206(10)63140-7","article-title":"Fluorescein-induced allergic reaction","volume":"81","author":"Lopez-Saez","year":"1998","journal-title":"Ann Allergy Asthma Immunol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e727","DOI":"10.1111\/aos.13797","article-title":"Retinal perfusion changes in radiation retinopathy","volume":"96","author":"Rose","year":"2018","journal-title":"Acta Ophthalmol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1007\/s00417-018-4036-3","article-title":"Quantification of radiation retinopathy after beam proton irradiation in centrally located choroidal melanoma","volume":"256","author":"Busch","year":"2018","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1159\/000490571","article-title":"Evaluation of vascular changes with optical coherence tomography angiography after plaque radiotherapy of choroidal melanoma","volume":"60","author":"Cennamo","year":"2018","journal-title":"Ophthalmic Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.3390\/jcm9061706","article-title":"Optical coherence tomography angiography in neurodegenerative disorders","volume":"9","author":"Pellegrini","year":"2020","journal-title":"J Clin Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1080\/08820538.2017.1416413","article-title":"Impact of different visual field instruction strategies on reliability indices","volume":"33","author":"Rao","year":"2018","journal-title":"Semin Ophthalmol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1097\/IAE.0000000000001021","article-title":"Optical coherence tomography angiography of the macula after plaque radiotherapy of choroidal melanoma: comparison of irradiated versus nonirradiated eyes in 65 patients","volume":"36","author":"Shields","year":"2016","journal-title":"Retina"},{"key":"B19","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.oret.2017.06.005","article-title":"Quantitative OCT angiography evaluation of peripapillary retinal circulation after plaque brachytherapy","volume":"2","author":"Skalet","year":"2018","journal-title":"Ophthalmol Retina"},{"key":"B20","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1038\/eye.2012.249","article-title":"Effects of radiotherapy on uveal melanomas and adjacent tissues","volume":"27","author":"Groenewald","year":"2013","journal-title":"Eye"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.1097\/IAE.0000000000001158","article-title":"Retinal vascular cystoid macular edema: review and new theory","volume":"36","author":"Spaide","year":"2016","journal-title":"Retina"},{"key":"B22","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.ajo.2017.06.008","article-title":"Optical coherence tomography angiography of macular features after proton beam radiotherapy for small choroidal melanoma","volume":"181","author":"Sellam","year":"2017","journal-title":"Am J Ophthalmol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/IAE.0b013e31814b1b75","article-title":"Early macular morphological changes following plaque radiotherapy for uveal melanoma","volume":"28","author":"Horgan","year":"2008","journal-title":"Retina"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1007\/s00417-016-3429-4","article-title":"Predictive risk factors for radiation retinopathy and optic neuropathy after proton beam therapy for uveal melanoma","volume":"254","author":"Seibel","year":"2016","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.preteyeres.2018.03.006","article-title":"The primate fovea: Structure, function and development","volume":"66","author":"Bringmann","year":"2018","journal-title":"Prog Retin Eye Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1016\/j.ophtha.2017.06.002","article-title":"Projection-resolved optical coherence tomography angiography of macular retinal circulation in glaucoma","volume":"124","author":"Takusagawa","year":"2017","journal-title":"Ophthalmology"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2400","DOI":"10.1097\/IAE.0000000000000844","article-title":"Noninvasive grading of radiation retinopathy: the use of optical coherence tomography angiography","volume":"35","author":"Veverka","year":"2015","journal-title":"Retina"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1136\/bjophthalmol-2017-311389","article-title":"Peripapillary vascular changes in radiation optic neuropathy: an optical coherence tomography angiography grading","volume":"102","author":"Parrozzani","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1016\/j.jocn.2012.05.034","article-title":"Late-onset radiation-induced optic neuropathy after radiotherapy for nasopharyngeal carcinoma","volume":"20","author":"Zhao","year":"2013","journal-title":"J Clin Neurosci"},{"key":"B30","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1097\/MOL.0b013e3282f0dd33","article-title":"Apolipoprotein B, apolipoprotein A-I, insulin resistance and the metabolic syndrome","volume":"18","author":"Sniderman","year":"2007","journal-title":"Curr Opin Lipidol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.jstrokecerebrovasdis.2009.09.010","article-title":"Apolipoprotein B-to-A1 ratio as a predictor of acute ischemic nonembolic stroke in elderly subjects","volume":"19","author":"Kostapanos","year":"2010","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"B32","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1111\/ene.12021","article-title":"Deep subcortical infarct burden in relation to apolipoprotein B\/AI ratio in patients with intracranial atherosclerotic stenosis","volume":"20","author":"Park","year":"2013","journal-title":"Eur J Neurol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1177\/1533034617711613","article-title":"Evaluation of the radiation dose-volume effects of optic nerves and chiasm by psychophysical, electrophysiologic tests, and optical coherence tomography in nasopharyngeal carcinoma","volume":"16","author":"Ozkaya Akagunduz","year":"2017","journal-title":"Technol Cancer Res Treat"},{"key":"B34","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1111\/ceo.12927","article-title":"Risk factors for radiation-induced optic neuropathy: a case-control study","volume":"45","author":"Ferguson","year":"2017","journal-title":"Clin Exp Ophthalmol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1001\/jamaophthalmol.2015.2225","article-title":"Optical coherence tomography angiography of the peripapillary retina in glaucoma","volume":"133","author":"Liu","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2498","DOI":"10.1016\/j.ophtha.2016.08.041","article-title":"Relationship between optical coherence tomography angiography vessel density and severity of visual field loss in glaucoma","volume":"123","author":"Yarmohammadi","year":"2016","journal-title":"Ophthalmology."},{"key":"B37","doi-asserted-by":"publisher","first-page":"3020","DOI":"10.1364\/BOE.3.003127","article-title":"Relationship among visual field, blood flow, and neural structure measurements in glaucoma","volume":"53","author":"Hwang","year":"2012","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1016\/S1470-2045(16)30410-7","article-title":"Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial","volume":"17","author":"Sun","year":"2016","journal-title":"Lancet Oncol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2020.630880\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T04:21:23Z","timestamp":1612326083000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2020.630880\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,3]]},"references-count":38,"alternative-id":["10.3389\/fmed.2020.630880"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2020.630880","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2021,2,3]]},"article-number":"630880"}}