Purchase this article with an account.
Xi Chen, Shwetha Mangalesh, Alexandria Dandridge, Du Tran-Viet, Christian Viehland, Francesco LaRocca, Joseph A. Izatt, Cynthia A Toth; Spectral-domain optical coherence tomography imaging of the retinal vascular-avascular junction in infants with retinopathy of prematurity. Invest. Ophthalmol. Vis. Sci. 2016;57(12):No Pagination Specified. doi: https://doi.org/.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. Development of bedside spectral domain optical coherence tomography (SDOCT) imaging has enabled new discoveries in retinal development and macular pathology associated with preterm birth. However, in vivo imaging of peripheral retina where most pathology takes place during ROP has been scarce.
We captured volumes of temporal retina at the vascular-avascular junction using the Bioptigen Envisu SDOCT system in the nursery in infants with ROP. B-scans and custom 3D reconstruction of the retinal surface were analyzed.
The vascular-avascular junction in the temporal retina was imaged in 14 eyes from 8 preterm infants with zone 1 or 2, stage 1 through 4 ROP. Inner retinal thickenings, consistent with “vanguard” tissue described in prior histological studies (Foos, 1987) were observed overlying the vascular-avascular junction. Vascularized retina was distinguishable from avascular retina by viewing the retinal “en face” projection image. In vascularized retina with or without neovascularization, the nerve fiber layer, ganglion cell layer, inner plexiform layer and inner nuclear layer were identifiable as distinct retinal layers. In avascular retina, a single hyperreflective layer was found above the inner nuclear layer. Outer retinal layers were the same on either side of the vascular-avascular junction. Neovascularization was readily visible and its morphology could be delineated in 3D. The inner retinal layers sometimes split anterior to, at, or posterior to the vascular-avascular junction with or without neovascularization.
It is possible to image the development of retinal layers at the vascular-avascular junction using bedside non-contact SDOCT imaging systems. These results provide novel in vivo information of retinal differentiation upon vascularization during ROP. With this new ability to visualize temporal and spatial changes in peripheral retina, we will now better understand neurovascular development during normal and pathological conditions.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
3D volume, B-scan and SVP projection of the temporal retina in a preterm infant with zone 1, stage 3 ROP. An elevated ridge of neovascularization was evident on 3D volume (left). The vascular-avascular junction is delineated on SVP image (right, dotted line) and marked on B-scan (middle, arrow).
This PDF is available to Subscribers Only