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Luvia Rodriguez Quiñones, Veronica Evangelina Giordano, Samantha Salinas Longoria, Virgilio Morales-Canton, Maria Ana Martinez-Castellanos; Structural and vascular developmental changes of the fovea in patients with spontaneously regressed retinopathy of prematurity assessed by fluorescein angiography and spectral domain OCT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5934.
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Midgestation is a critical period in the formation of the foveal avascular zone, premature birth interrupts the normal intrauterine foveal development. The purpose of the study is to assess the developmental changes in the fovea of patients born prematurely with spontaneously regressed ROP.
Prospective observational case series. We obtained Spectral-domain optical coherence tomography (SD-OCT) in a 9-mm line scans across the fovea of patients with retinopathy of prematurity with spontaneous regression every 2 weeks until they reached week 50 of corrected gestational age, total retinal thickness and individual retinal layer thickness were measured. Fluorescein angiography was performed using a wide angle device (130 grades lens) in an intravenous bolus of 0.1ml/kg saline fluorescein 20% every 2 weeks until the resolution of ROP or when the week 50 was reached. Both procedures were performed under topical anesthesia (tetracain 0.5%) and no sedation
We included twenty three eyes of 12 patients with spontaneusly regressed ROP. Mean gestational age at birth was 30 weeks (range 25-33), average birth weight was 1,302 grams (range 780-2500), mean gestational age at the first was 34 weeks (range 29-36) and at last study was 50.09 weeks. We included three patients with stage 2 zone 2, one patient with stage 2, zone 2 pre-plus, 8 patients with stage 3 zone 2 no plus.We assessed several signs of immaturity in the neonates: a shallow or absent foveal pit that will change by week 44 and will be obvious at week 50 in all patients, persistence of inner retinal layers that varies of thickness as the eye matures, a thin photoreceptor layer that does change reaching the week 50. Angiography findings showed absence of foveal avascular zone (FAZ) with vascular leakage in what is preasumed is the macular area, reaching week 44 FAZ is started to be noticed and on week 50 the FAZ could be noticed in every patient.
This study provides a view into the development of living cellular layers and vessels of the human macula in premature infant eyes. We found a sequential framework of the timeline of human foveal development after week 34. Our findings may help to identify patterns of retina maturation opening the possibility to find new keys to disease mechanisms.
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