Neuroinflammation in Radiation Maculopathy: A Pathophysiologic and Imaging Perspective.

Area of Science:

• Ophthalmology
• Neuroscience
• Radiology

Background:

• Radiation maculopathy (RM) is a severe complication of ocular radiotherapy.
• Emerging evidence highlights neuroinflammation, involving microglial activation and cytokine dysregulation, as central to RM pathogenesis.
• Hyperreflective retinal foci of neuroinflammatory origin (I-HRF) are critical early biomarkers.

Purpose of the Study:

• To review the pathophysiology of neuroinflammation in RM.
• To explore associated imaging parameters, particularly I-HRF.
• To synthesize experimental and clinical findings on RM biomarkers.

Main Methods:

• Literature review of experimental and clinical studies.
• Synthesis of data on neuroinflammation in RM.
• Focus on optical coherence tomography (OCT) for imaging biomarkers.

Main Results:

• I-HRF are significant early indicators of neuroinflammation in RM.
• OCT facilitates the identification and quantification of I-HRF.
• These biomarkers correlate with microglial activation and cytokine changes.

Conclusions:

• RM pathophysiology is shifting from a vascular to a neuroinflammatory paradigm.
• I-HRF serve as crucial early biomarkers for RM.
• I-HRF enable potential preclinical diagnosis and therapeutic strategies for RM.