Changes in the micromorphology of the corneal subbasal nerve plexus in patients after plaque brachytherapy
Tóm tắt
To quantify the development of radiation neuropathy in corneal subbasal nerve plexus (SNP) after plaque brachytherapy, and the subsequent regeneration of SNP micromorphology and corneal sensation. Nine eyes of 9 melanoma patients (ciliary body: 3, iris: 2, conjunctiva: 4) underwent brachytherapy (ruthenium-106 plaque, dose to tumour base: 523 ± 231 Gy). SNP micromorphology was assessed by in-vivo confocal microscopy. Using software developed in–house, pre-irradiation findings were compared with those obtained after 3 days, 1, 4 and 7 months, and related to radiation dose and corneal sensation. After 3 days nerve fibres were absent from the applicator zone and central cornea, and corneal sensation was abolished. The earliest regenerating fibres were seen at the one-month follow-up. By 4 months SNP structures had increased to one-third of pre-treatment status (based on nerve fibre density and nerve fibre count), and corneal sensation had returned to approximately two-thirds of pre-irradiation values. Regeneration of SNP and corneal sensation was nearly complete 7 months after plaque brachytherapy. The evaluation of SNP micromorphology and corneal sensation is a reliable and clinically useful method for assessing neuropathy after plaque brachytherapy. Radiation-induced neuropathy of corneal nerves develops quickly and is partly reversible within 7 months. The clinical impact of radiation-induced SNP damage is moderate.
Tài liệu tham khảo
Char DH, Quivey JM, Castro JR, Kroll S, Phillips T: Helium ions versus iodine 125 brachytherapy in the management of uveal melanoma. A prospective, randomized, dynamically balanced trial. Ophthalmology 1993, 100: 1547-1554.
Bergman L, Nilsson B, Lundell G, Lundell M, Seregard S: Ruthenium brachytherapy for uveal melanoma, 1979–2003: survival and functional outcomes in the Swedish population. Ophthalmology 2005, 112: 834-840. 10.1016/j.ophtha.2004.11.038
Guthoff R, Frischmuth J, Jensen OA, Bjerrum K, Prause JU: Choroid melanoma. A retrospective randomized comparative study of ruthenium irradiation vs enucleation. Klin Monbl Augenheilkd 1992, 200: 257-261. 10.1055/s-2008-1045748
Lommatzsch PK, Werschnik C, Schuster E: Long-term follow-up of Ru-106/Rh-106 brachytherapy for posterior uveal melanoma. Graefes Arch Clin Exp Ophthalmol 2000, 238: 129-137. 10.1007/PL00007880
Lommatzsch PK, Alberti W, Lommatzsch R, Rohrwacher F: Radiation effects on the optic nerve observed after brachytherapy of choroidal melanomas with 106Ru/106Rh plaques. Graefes Arch Clin Exp Ophthalmol 1994, 232: 482-487. 10.1007/BF00195358
Chan MF, Fung AY, Hu YC, Chui CS, Amols H, Zaider M, Abramson D: The measurement of three dimensional dose distribution of a ruthenium-106 ophthalmological applicator using magnetic resonance imaging of BANG polymer gels. J Appl Clin Med Phys 2001, 2: 85-89. 10.1120/1.1351776
Summanen P, Immonen I, Kivela T, Tommila P, Heikkonen J, Tarkkanen A: Radiation related complications after ruthenium plaque radiotherapy of uveal melanoma. Br J Ophthalmol 1996, 80: 732-739. 10.1136/bjo.80.8.732
Patel DV, Tavakoli M, Craig JP, Efron N, McGhee CN: Corneal sensitivity and slit scanning in vivo confocal microscopy of the subbasal nerve plexus of the normal central and peripheral human cornea. Cornea 2009, 28: 735-740. 10.1097/ICO.0b013e318193e0e3
Patel DV, McGhee CN: In vivo laser scanning confocal microscopy confirms that the human corneal sub-basal nerve plexus is a highly dynamic structure. Invest Ophthalmol Vis Sci 2008, 49: 3409-3412. 10.1167/iovs.08-1951
Guthoff RF, Zhivov A, Stachs O: In vivo confocal microscopy, an inner vision of the cornea - a major review. Clin Experiment Ophthalmol 2009, 37: 100-117. 10.1111/j.1442-9071.2009.02016.x
Stachs O, Zhivov A, Kraak R, Hovakimyan M, Wree A, Guthoff R: Structural-functional correlations of corneal innervation after LASIK and penetrating keratoplasty. J Refract Surg 2010, 26: 159-167.
Richter A, Slowik C, Somodi S, Vick HP, Guthoff R: Corneal reinnervation following penetrating keratoplasty–correlation of esthesiometry and confocal microscopy. Ger J Ophthalmol 1996, 5: 513-517.
Patel SV, Erie JC, McLaren JW, Bourne WM: Keratocyte and subbasal nerve density after penetrating keratoplasty. Trans Am Ophthalmol Soc 2007, 105: 180-189.
Zhang F, Deng S, Guo N, Wang M, Sun X: Confocal comparison of corneal nerve regeneration and keratocyte reaction between FS-LASIK, OUP-SBK, and conventional LASIK. Invest Ophthalmol Vis Sci 2012,53(9):5536-44. 10.1167/iovs.11-8786
Tavakoli M, Petropoulos IN, Malik RA: Assessing corneal nerve structure and function in diabetic neuropathy. Clin Exp Optom 2012, 95: 338-347. 10.1111/j.1444-0938.2012.00743.x
Zhivov A, Winter K, Hovakimyan M, Peschel S, Harder V, Schober HC, Kundt G, Baltrusch S, Guthoff RF, Stachs O: Imaging and quantification of subbasal nerve plexus in healthy volunteers and diabetic patients with or without retinopathy. PLoS One 2013, 8: e52157. 10.1371/journal.pone.0052157
Falke K, Büttner A, Schittkowski M, Stachs O, Kraak R, Zhivov A, Rolfs A, Guthoff RF: The microstructure of cornea verticillata in Fabry disease and amiodarone-induced keratopathy: a confocal laser-scanning microscopy study. Graefes Arch Clin Exp Ophthalmol 2009, 247: 523-534. 10.1007/s00417-008-0962-9
Zhivov A, Blum M, Guthoff R, Stachs O: Real-time mapping of the subepithelial nerve plexus by in vivo confocal laser scanning microscopy. Br J Ophthalmol 2010, 94: 1133-1135. 10.1136/bjo.2009.175489
Winter K, Zhivov A, Guthoff RF, Koehler B, Stachs O: Characteristic quantities for the quantification of CLSM images of the subbasal nerve plexus. Biomed Tech 2010, 55: 252-254.
Zhivov A, Stachs O, Kraak R, Stave J, Guthoff RF: In vivo confocal microscopy of the ocular surface. Ocul Surf 2006, 4: 81-93. 10.1016/S1542-0124(12)70030-7
Cleeland CS, Farrar JT, Hausheer FH: Assessment of cancer-related neuropathy and neuropathic pain. Oncologist 2010,15(Suppl 2):13-18.
Johansson S, Svensson H, Denekamp J: Timescale of evolution of late radiation injury after postoperative radiotherapy of breast cancer patients. Int J Radiat Oncol Biol Phys 2000, 48: 745-750. 10.1016/S0360-3016(00)00674-X
Gerard JM, Franck N, Moussa Z, Hildebrand J: Acute ischemic brachial plexus neuropathy following radiation therapy. Neurology 1989, 39: 450-451. 10.1212/WNL.39.3.450
Lin Z, Wu VW, Ju W, Yamada Y, Chen L: Radiation-induced changes in peripheral nerve by stereotactic radiosurgery: a study on the sciatic nerve of rabbit. J Neurooncol 2011, 102: 179-185. 10.1007/s11060-010-0309-3
Ballian N, Androulakis II, Chatzistefanou K, Samara C, Tsiveriotis K, Kaltsas GA: Optic neuropathy following radiotherapy for Cushing’s disease: case report and literature review. Hormones (Athens) 2010, 9: 269-273.
Tavakoli M, Quattrini C, Abbott C, Kallinikos P, Marshall A, Finnigan J, Morgan P, Efron N, Boulton AJ, Malik RA: Corneal confocal microscopy: a novel noninvasive test to diagnose and stratify the severity of human diabetic neuropathy. Diabetes Care 2010, 33: 1792-1797. 10.2337/dc10-0253
Messmer EM, Schmid-Tannwald C, Zapp D, Kampik A: In vivo confocal microscopy of corneal small fiber damage in diabetes mellitus. Graefes Arch Clin Exp Ophthalmol 2010, 248: 1307-1312. 10.1007/s00417-010-1396-8
Tavakoli M, Marshall A, Thompson L, Kenny M, Waldek S, Efron N, Malik RA: Corneal confocal microscopy: a novel noninvasive means to diagnose neuropathy in patients with Fabry disease. Muscle Nerve 2009, 40: 976-984. 10.1002/mus.21383
Patel DV, McGhee CN: In vivo confocal microscopy of human corneal nerves in health, in ocular and systemic disease, and following corneal surgery: a review. Br J Ophthalmol 2009, 93: 853-860. 10.1136/bjo.2008.150615
Al-Aqaba MA, Fares U, Suleman H, Lowe J, Dua HS: Architecture and distribution of human corneal nerves. Br J Ophthalmol 2010, 94: 784-789. 10.1136/bjo.2009.173799
Allgeier S, Zhivov A, Eberle F, Koehler B, Maier S, Bretthauer G, Guthoff RF, Stachs O: Image reconstruction of the subbasal nerve plexus with in vivo confocal microscopy. Invest Ophthalmol Vis Sci 2011, 52: 5022-5028. 10.1167/iovs.10-6065
Tervo T, Vannas A, Tervo K, Holden BA: Histochemical evidence of limited reinnervation of human corneal grafts. Acta Ophthalmol (Copenh) 1985, 63: 207-214.
Ruben M, Colebrook E: Keratoplasty sensitivity. Br J Ophthalmol 1979, 63: 265-267. 10.1136/bjo.63.4.265
Erie JC, McLaren JW, Hodge DO, Bourne WM: Recovery of corneal subbasal nerve density after PRK and LASIK. Am J Ophthalmol 2005, 140: 1059-1064. 10.1016/j.ajo.2005.07.027
Knappe S, Stachs O, Zhivov A, Hovakimyan M, Guthoff R: Results of confocal microscopy examinations after collagen cross-linking with riboflavin and UVA light in patients with progressive keratoconus. Ophthalmologica 2011, 225: 95-104. 10.1159/000319465
Mazzotta C, Balestrazzi A, Traversi C, Baiocchi S, Caporossi T, Tommasi C, Caporossi A: Treatment of progressive keratoconus by riboflavin-UVA-induced cross-linking of corneal collagen: ultrastructural analysis by Heidelberg Retinal Tomograph II in vivo confocal microscopy in humans. Cornea 2007, 26: 390-397. 10.1097/ICO.0b013e318030df5a