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Xi Chen, Christian Viehland, Du Tran-Viet, Joseph A Izatt, Cynthia A Toth; Capturing macular neurovascular development in infants with retinopathy of prematurity. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4755.
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© ARVO (1962-2015); The Authors (2016-present)
Histopathological studies laid the foundation for our current understanding of human macular neurovascular development. The advent of bedside handheld optical tomography (OCT) imaging offers us an opportunity to observe in situ human retinal development.
Under IRB-approved protocol, we report the use of an investigational handheld noncontact swept source OCT system capable of OCT angiography (OCTA, 200 kHz swept source OCT engine, 300 A-scans/B-scans, 4 repeated B-scans, 300 lateral locations, 2.4 seconds scan duration) to capture at the bedside, moments of macular development.
We imaged at the bedside and in clinic with research structural and angiographic OCT in 15 preterm infants as young as 33 weeks post menstrual age (PMA). We captured vascular flow in the superficial perifoveal capillaries surrounding the impending fovea at the temporal notch (Figure), as well as the formation of a foveal avascular zone in the same eye 1 and 2 weeks later. We also obtained imaging of both superficial and deep vascular complexes in other preterm infants with or without pharmacological dilation. Quality of the OCTA scans are affected by motion and focus adjustment. While these in vivo observations are consistent with our prior knowledge from histopathological studies, we document noninvasively the precise timing and phases of macular development.
OCTA images from preterm infants of 33 weeks PMA document the earliest views of capillary vascular flow in the developing perifoveal retinal vasculature. We have captured with and identified methods to improve bedside noncontact handheld OCTA imaging. These imaging advancements will provide insights in future studies of retinal neurovascular development and pathology.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
OCT en face view of an eye of a preterm infant at 33 weeks PMA showed immature vascular development with a temporal notch (A and C, cross-sectional view in B). OCTA imaging captured the vascular flow at the edge of the temporal notch surrounding an impending fovea prior to formation of a foveal avascular zone (D).
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