Influence of Foveal Photoreceptor Sub-Elements On Visual Acuity In Premature Infants With And Without Retinopathy Of Prematurity

Abstract

 

Purpose:

 

To correlate inner retinal layer (IRL) migration, external limiting membrane (ELM), Photoreceptor Inner Segment-Outer Segment (IS-OS) and Outer Segment- Retinal Pigment Epithelium (OS-RPE) layers at the foveal centre imaged on the hand-held Spectral Domain OCT (Bioptigen Inc.,NC) with visual acuity in the first year of life.

 

Methods:

 

Fifty-seven Asian Indian premature infants underwent SD-OCT imaging between postmenstrual ages of 34 weeks and 12 months. Thirty-three (52.6%) infants were imaged at intervals of 3,6,9 and 12 months corrected age during which vision was additionally assessed with Teller acuity cards (TAC). Sixty-four eyes (56.1%) historically had a maximum level of Type II (untreated) Retinopathy of Prematurity (ROP). Two masked readers assessed the foveal photoreceptor sub-elements at each imaging session as per study protocol. Foveal morphology was correlated with vision and the presence of ROP.

 

Results:

 

Kormoglov-Smirnoff test was performed on the data. Spearman’s Correlation Coefficient found that the presence of ROP correlated negatively with the presence of ELM (r= - 0.196;p= 0.039) and IS-OS (r= - 0.330;p< 0.001) observed on SD-OCT and positively correlated increased visual acuity with the presence of foveal layers [IRL fusion (r=0.391;p=0.002), ELM (r=0.340;p=0.007) and OS-RPE (r=0.309;p=0.015)] at 0.01 level of 2-tailed significance.

 

Conclusions:

 

The study provides new insights into our understanding of foveal maturation in the first year of life. Subcellular photoreceptor specialization in premature infants correlates positively with improved visual acuity. Infants with Type II ROP show delayed development in foveal differentiation and maturation.  

 

Keywords: retinopathy of prematurity • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • infant vision