June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Foveal development in treated and untreated infants with retinopathy of prematurity observed with handheld spectral-domain optical coherence tomography
Author Affiliations & Notes
  • Oladipo Fagbemi
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Ryan Vogel
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Phyllis Summerfelt
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Deborah Costakos
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Footnotes
    Commercial Relationships   Oladipo Fagbemi, None; Ryan Vogel, None; Phyllis Summerfelt, None; Deborah Costakos, None
  • Footnotes
    Support   Russell J. and Betty Jane Shaw Fund of the Greater Milwaukee Foundation and Grant P30EY001931
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5540. doi:
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      Oladipo Fagbemi, Ryan Vogel, Phyllis Summerfelt, Deborah Costakos; Foveal development in treated and untreated infants with retinopathy of prematurity observed with handheld spectral-domain optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5540.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Management of retinopathy of prematurity (ROP) involves routine screening, as well as laser photocoagulation (LP) and/or intravitreal anti-VEGF therapy for clinically indicated cases. The effect of these treatments on foveal development is not well established. We used spectral-domain optical coherence tomography (SD-OCT) to analyze subclinical macular findings in infants with ROP including those who underwent treatment with LP or bevacizumab.

Methods : Handheld SD-OCT imaging was performed longitudinally on 86 subjects (156 eyes) at Children’s Hospital of Wisconsin during routine ROP exams. Factors for analysis included foveal pit depth (central foveal thickness/rim thickness), outer retinal thickness (ORT) ratio at the foveal center, and the presence of cystoid macular edema (CME), epiretinal membrane (ERM), and hyperreflective vitreous material (HVM).

Results : Usable scans were obtained in 87% of imaging sessions. Of these 393 scans, 49 were post-bevacizumab only, 6 were post-LP only, 4 were post-both treatments, and 334 were treatment-naïve eyes. Using within-subject analysis and excluding images with foveal CME, the percent change per week for foveal pit depth and ORT ratio were recorded (see table). The change in foveal pit depth per week was significantly less for post-bevacizumab eyes compared to treatment-naïve eyes (p=0.048). New CME developed in 25% of treatment-naïve eyes, 43% of post-bevacizumab eyes, 0% of post-LP eyes. New CME developed significantly more often in post-bevacizumab versus post-LP eyes (p=0.0171). No difference was found in the development of new CME between treatment-naïve eyes versus either treatment group. Of eyes that reached stage 3 ROP, ERM was found in 96% and HVM in 46%.

Conclusions : SD-OCT imaging of infants with ROP shows progressive deepening of the foveal pit and thickening of the outer retinal layers, relative to the central foveal thickness. Foveal pit development was delayed in eyes treated with bevacizumab. Development of CME is more likely post-bevacizumab than post-LP. ERM and HVM were prevalent in eyes that reached stage 3 and may be an outcome of neovascular development seen in ROP. Further study is needed to determine the clinical significance of these findings and the long-term visual outcome of delayed foveal maturation.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 


Percent change per week for each treatment group (t-test, *p≤0.05).


Percent change per week for each treatment group (t-test, *p≤0.05).

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