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Understanding clinically undetected macular changes in early retinopathy of prematurity on spectral domain optical coherence tomography.

Abstract：

PURPOSE:To investigate macular changes in acute retinopathy of prematurity (ROP). METHODS:Fifty-four premature infants with ROP and 20 controls underwent routine ROP screening with indirect ophthalmoscopy and imaging. A tabletop spectral domain optical coherence tomography (SD-OCT) scanner (Spectralis; Heidelberg Engineering, Heidelberg, Germany) was converted into a handheld device to image infants in the office sans sedation. RESULTS:SD-OCT images were obtained in all infants in the office. On SD-OCT, 23 of 79 eyes (29.1%) with stage 2 ROP showed abnormal foveal changes despite clinically normal foveae. Of the 23 eyes, 2 distinct patterns of foveal involvement were observed: "pattern A," which was characterized by dome-shaped foveal elevation and cystoid spaces with highly reflective intervening vertical septae, and "pattern B," which was characterized by preservation of the foveal depression with fewer intraretinal cystoid spaces. These patterns were seen in 12 (52.2%) and 11 (47.8%) eyes, respectively. All eyes (100%) belonging to stage 1 ROP (27) and the normal group (40) had no abnormal SD-OCT changes. The mean central foveal thickness was 156.9 ± 28.3 μm, 206.5 ± 98.7 μm, and 135.9 ± 17.6 μm for stage 1, 2, and normal eyes, respectively (P < 0.001). Nineteen of the 23 eyes underwent serial imaging at 52 weeks' postmenstrual age (PMA), and all of them revealed normalization of foveal contours at this visit. CONCLUSIONS:SD-OCT changes of the macula in mild ROP have not been previously described. Our method reveals that infants may be imaged supine and unanesthetized in the office. We hypothesize that these transient foveal changes at the critical time of fovealization in premature infants may influence their visual acuity in the adult life.

journal_name

Invest Ophthalmol Vis Sci

journal_title

Investigative ophthalmology & visual science

authors

Vinekar A,Avadhani K,Sivakumar M,Mahendradas P,Kurian M,Braganza S,Shetty R,Shetty BK

doi

10.1167/iovs.10-7155

subject

Has Abstract

pub_date

2011-07-15 00:00:00

pages

5183-8

issue

eissn

0146-0404

issn

1552-5783

pii

iovs.10-7155

journal_volume

pub_type

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Understanding clinically undetected macular changes in early retinopathy of prematurity on spectral domain optical coherence tomography.