Abstract
Purpose:
To describe vascular features observed with Spectral Domain Optical Coherence (SDOCT) in subjects with Retinopathy of Prematurity (ROP) before the development of plus disease.
Methods:
Retrospective observational case-series, comparing clinical and SDOCT retinal findings. Three neonates undergoing ROP screening that had portable handheld SDOCT imaging were included. Neonates A and B were identical twins that required laser treatment for Type 1 ROP at 36 weeks post-menstrual age (PMA). Neonate C did not require laser, had only mild ROP and served as a control. SDOCT imaging session at 33, 34 and 35 weeks post-menstrual age (PMA) were analyzed. SDOCT characteristics graded were: 1) retinal vessel elevation, 2) scalloped retinal layers, 3) hyporeflective vessels and 4) perivascular retinal spaces.
Results:
Neonates A, B and C were each born at 24 weeks PMA with birth weights of 590, 542 and 650 grams, respectively. ROP stage 3 with plus in Zone 1 (type I ROP) developed in both eyes of Neonate A at 36 weeks PMA, and Neonate B at 35 weeks. Neonate C developed ROP that reached only stage 2 with no vascular abnormalities on any of the exams. Retinal vessel elevation and scalloped retinal layers were observed in Neonate A at all three examinations (33,34,35 weeks), and in Neonate B at 35 weeks PMA. Hyporeflective vessels were present only in Neonate A (at 34 weeks PMA). None of the infants showed perivascular retinal spaces. Although retinal vessel elevation was initially noted for Neonate C at 33 weeks PMA (but not at 34 or 35 weeks PMA), analysis of retinal surface maps revealed “true” retinal vessel elevation only in neonates A and B.
Conclusions:
Retinal vessel elevation and scalloped retinal layers were SDOCT imaging markers correlating with, and sometimes noted prior to the clinic diagnosis of plus disease, in this small subset of patients. Three-dimensional Retinal Surface Maps provide a more objective measure of vessel elevation. Larger studies using Portable handheld SDOCT will help to determine the usefulness of these vascular features as objective clinical features of plus disease.
Keywords: 706 retinopathy of prematurity •
552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) •
688 retina