Abstract
Purpose :
Retinopathy of prematurity (ROP) is an important cause of preventable blindness necessitating multiple examinations during early development. Ultra-high resolution spectral domain hand-held OCT (HHOCT) provides detailed imaging of important retinal structures in premature infants and may be a useful additional screening tool. We describe the optic nerve head (ONH) development for premature infants aged between 30-42 weeks postmenstrual age (PMA) screened for ROP.
Methods :
121 premature infants (≤32 weeks gestational age at birth or ≤1500g birth weight) were recruited to the study. Early prognostic changes in the ONH were evaluated by grouping infants according to the final ROP outcome; none (group 1), regressed without treatment (group 2), or treated with laser (group 3). Ophthalmic examination and HHOCT scan (Leica Microsystems, 2.6µm axial resolution) were performed between 30-42 weeks PMA without sedation. ONH images were analysed using a customised macro in ImageJ. Diametric parameters were quantified and peri-papillary parameters were calculated at 6° from the disc centre. Developmental trajectories were compared between groups using fractional polynomial modelling.
Results :
All optic nerve head parameters were statistically similar for the two least severe ROP groups between 30-42 weeks PMA (group 2 compared to group 1: p>0.05). Infants requiring laser demonstrated a smaller disc diameter compared to infants without ROP throughout early development (group 3 compared to group 1: p<0.05). At 32 weeks PMA the cup diameter was 32% smaller in group 3 compared to group 1 infants (p=0.005), increasing to a statistically similar size by 40 weeks PMA. The nasal and temporal basement membrane opening minimum rim width (BMO-MRW) were initially 24% and 22% greater, respectively, in group 3 compared to group 1 infants (p<0.05), and also reached statistical equivalence by 40 weeks PMA.
Conclusions :
We report the developmental trajectory of ONH parameters for premature infants 30-42 weeks PMA for the first time using HHOCT. Our results demonstrate smaller optic disc and cup diameter and greater BMO-MRW at 32 weeks PMA for infants who develop ROP requiring laser treatment compared to infants who do not develop any ROP. These results may be useful for risk-stratifying patients for ROP screening.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.