Feasibility of Color Doppler Spectral Domain Optical Coherence Tomography in premature infants undergoing Retinopathy of Prematurity screening

Abstract

Purpose: We have previously identified on Spectral Domain Optical Coherence Tomography (SDOCT), elevated hyporeflective vessels, perivascular changes, and scalloped retinal layers in neonates with plus disease. We aim to evaluate the feasibility of performing Color Doppler SDOCT (CD-SDOCT) in premature neonates undergoing screening for retinopathy of prematurity (ROP).

Methods: Retrospective analysis of all CD-SDOCT images obtained from January 2009 to October 2012 in preterm neonates ages 31-41 weeks postmenstrual age undergoing ROP screening. Images were obtained using an 840 nm wavelength SD-OCT system (Bioptigen. Inc). One randomly selected eye from each infant was used for analysis. Information on ROP status was obtained from case report forms. Feasibility was assessed by determining whether or not (1) a Doppler signal could be detected, and (2) an en-face retinal image (RI) could be generated. RI was graded as good (no motion artifacts), fair (few motion artifacts) or poor (undistinguishable vessel pattern). With increasing flow velocity, Doppler signal could be absent, present or present with phase-wrapping (colored rings within vessel lumen indicating higher flow velocity).

Results: Ten subjects had plus disease and 10 had ROP stage 0-2 and no plus disease at time imaging. 17 scans were captured in the vertical direction while only 3 in the horizontal direction. Doppler signal was detectable in 15/20 (75%) eyes, 10/10 (100%) of the plus disease subjects and 6/10 (60%) of the non-plus subjects. RI was scored as Good in 9/20 (45%), Fair in 8/20 (40%) and Poor in 3/20 (15%). Phase-wrapping phenomenon was detected only in 4 eyes, all of them with plus disease and stage 3 ROP.

Conclusions: CD-SDOCT signal was better detected in eyes with plus disease. The phase wrapping phenomenon may represent flow abnormalities present in these subjects. CD-SDOCT may potentially aid in future analysis of flow changes in ROP and disease progression. Hardware and software improvements are required to increase quantification of flow in this imaging modality.

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