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Ryan N. Vogel, Alana D. Trotter, Mara R Goldberg, Deborah M Costakos; Subclinical macular findings in infants with retinopathy of prematurity treated with bevacizumab or laser photocoagulation. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6306.
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© ARVO (1962-2015); The Authors (2016-present)
Laser photocoagulation and intravitreal bevacizumab are frequently used in the treatment of retinopathy of prematurity (ROP), but the effect of these treatments on foveal development is not well established. We used handheld spectral-domain optical coherence tomography (SD-OCT) to compare subclinical macular findings in infants who underwent treatment for ROP and those who regressed spontaneously.
Handheld SD-OCT imaging was performed longitudinally on infants at Children’s Hospital of Wisconsin during routine ROP exams. Subjects were included in the study if they developed stage 3 ROP. Factors for analysis included presence of cystoid macular edema (CME), foveal pit depth (parafoveal/central foveal thickness ratio), inner retinal thickness, and outer retinal maturation at the fovea (distance of ellipsoid zone (EZ) from foveal center).
Thirty-six eyes from 18 patients met study criteria. Of those, 4 underwent treatment with laser photocoagulation, 4 with bevacizumab, and 1 with both treatments. CME was found in 12 eyes (33.3%). Four eyes developed new CME following bevacizumab and two following laser treatment. Using within-subject analysis and excluding images with foveal CME, the foveal pit increased in depth by 4.05% per week (±2.76 SD). Inner retinal thickness at the foveal center decreased by 5.10% per week (±2.75 SD). The distance of the EZ from the foveal center decreased by 12.71% per week (±2.44 SD). There was no statistically significant difference between bevacizumab-treated and untreated eyes for any of these measurements (p=0.52, 0.78, and 0.64 respectively). There were no consecutive post-laser treatment images available for these analyses. Hyperreflective vitreous structures were found in 4 out of 8 eyes following bevacizumab treatment and 4 out of 6 eyes following laser treatment, but were not found in untreated eyes.
Treatment with bevacizumab or laser photocoagulation does not appear to be correlated with the presence of CME, foveal pit development, inner retinal thickness, or outer retinal maturation in infants with ROP. Hyperreflective vitreous structures were found exclusively in bevacizumab- and laser-treated eyes. Further research is needed to determine the clinical significance of this finding.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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