Correlation of clinically undetected macular features by spectral domain OCT and angiography in early stages of retinopathy of prematurity

Abstract

 

Purpose

 

To describe and correlate the fluorescein angiography (FA) and hand held spectral domain optical coherence tomography (HH-SD OCT) macular findings in eyes with stage 1 and 2 ROP with a clinically normal appearing macula.

 

Methods

 

Observational, retrospective case series of infants who underwent routine screening with indirect ophthalmoscopy and imaging under topical anesthesia. Imaging included retinal FA using the Retcam II (Clarity Medical Systems, Pleasanton, CA) and hand held spectral domain OCT imaging with iVue (Optovue, Inc, Freemont, CA)

 

Results

 

We included 12 eyes of 7 infants that were diagnosed with ROP stage 1 or 2 in zones II and III with clinically normal macula, but by angiography presented an abnormal diffuse capillary leakage pattern in the parafoveal area. Mean gestational age at birth was 29.5 weeks (range 26-33 weeks) . Mean postmenstrual age (PMA) was 39.8 weeks (range 34-44 weeks). Retinal FA of the 12 eyes (100%) showed an angiographic diffuse capillary leakage pattern . OCT studies of 3 eyes (25%) showed no macular abnormalities . 9 eyes (75%) presented intraretinal cystoid spaces with preservation of the foveal depression . This findings regressed once the retinal vasculature reached the ora serrata. 3 eyes (25%) presented a probable epiretinal membrane formation.

 

Conclusions

 

Macular abnormalities of premature infant eyes with ROP seen on angiographic or tomographic evaluation might reflect variability in remodeling of foveal architecture during development either neural, vascular or both. The vascular changes could be explained due to parietal leakage because of vascular immaturity, related to the formation and the maturation of the mural cells (perycites). The abnormalities seen by OCT may explain the deficits in acuity, color and visual sensitivity in adulthood. This pilot study provides valuable information of macular findings of patients with mild ROP. A larger series with longer follow up is needed, in order to know if these subtles changes can influence the final macular morphology and visual acuity in adulthood.

 

Keywords: 706 retinopathy of prematurity • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 550 imaging/image analysis: clinical