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David Xu, Daniel Su, Madeline Del Signore, Sherwin Isenberg, David Sarraf; Immature photoreceptor layer and inner retinal layers in full term neonates identified with optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2017;58(8):109.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to determine the morphologic structure of the human fovea in healthy, full term neonates using spectral-domain optical coherence tomography (SD-OCT).
A total of 19 full term newborns were enrolled in this prospective observational study. Patients were excluded if they were premature or had a complicated antenatal or perinatal course. Healthy newborns 1 to 3 days of age underwent macular and optic nerve imaging using a tabletop SD-OCT system (Heidelberg Spectralis, Franklin, MA). Twenty-four eyes of 14 patients yielded SD-OCT cross sectional B scans of the fovea of adequate quality and were included in the final analysis. Scans were assessed for presence of the central ellipsoid zone (EZ) band, external limiting membrane (ELM) and inner retinal layers (IRL), and any evidence of cystoid macular edema (CME). The central macular thickness (CMT) and width of the foveal depression (WFD) were measured.
Median gestational age was 39 weeks (range 38 to 41 weeks). The central EZ band was not identified in 17 of 24 eyes (71%) while the central ELM band was absent in 21 eyes (88%). In eyes without a central EZ band, this band could be identified in the parafoveal macula with gradual thinning and disappearance approaching the central fovea. The presence of inner retinal layers was identified in 19 eyes (79%). CME was present in 3 eyes (13%). The mean CMT was 97 ± 20 microns and the mean width of the foveal depression was 2.08 ± 0.37 mm.
Spectral domain OCT studies of the central macula in healthy, full-term newborn eyes are lacking. OCT analysis of the fovea at birth demonstrated findings of immaturity including incomplete development of the photoreceptor inner and outer segments while the inner retinal layers were well developed in the majority of cases. We demonstrate the feasibility of imaging neonates with a tabletop SD-OCT system.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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