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Brittany M. Wong, Alison Chu, Nicholas N Zoppi, Niranjan Manoharan, Artemiy Kokhanov, Alex S. Huang, Irena Tsui; Cystoid macular edema on optical coherence tomography correlated with worse intraventricular hemorrhage in preterm neonates. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2170.
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© ARVO (1962-2015); The Authors (2016-present)
Cystoid macular edema (CME) has been reported in approximately 50% of preterm infants on optical coherence tomography (OCT) imaging, but remains poorly understood. History of CME has been associated with poorer neurodevelopmental outcomes. We hypothesized that CME presence correlates to neurological co-morbidities of prematurity.
We imaged preterm infants undergoing ROP screening (<30 weeks gestational age (GA), or <1500 g birthweight (BW), or at the request of neonatology for other clinical indications) at the University of California Los Angeles using a portable Spectralis Flex OCT Module (Heidelberg Engineering GmbH, Heidelberg, Germany) under an Institutional Review Board protocol. OCT images of one eye per infant were analyzed for CME presence. We collected other demographic and clinical information including ROP stage and treatment, intraventricular hemorrhage (IVH) presence and severity, post-hemorrhagic hydrocephalus and/or need for surgical intervention, patent ductus arteriosus (PDA), bronchopulmonary dysplasia (BPD), infections, and intrauterine growth restriction (IUGR).
17 infants were imaged (GA: range 22.1-34.0, mean 27.5 ± 3.5 weeks; BW: 360-2400, mean 1015.3 ± 506.4 g; post-menstrual age (PMA) at imaging: 32.4-47.4, mean 37.0 ± 4.3 weeks). CME was observed bilaterally in 7 infants. There was a significant correlation between CME presence and IVH grade (p = 0.04, Chi-square test). Two infants had hydrocephalus requiring ventriculoperitoneal (VP) shunt placement; both had CME, one parafoveal and one severe foveal. Between infants with and without CME, there was no significant difference in gender, GA, BW, PMA at imaging, PDA presence or treatment, BPD, infection, or IUGR. CME presence was not associated with maximum ROP stage, zone, plus disease, or treatment. Interestingly, CME regressed in one infant after laser treatment and one after VP shunt placement.
CME presence was not associated with ROP stage, but did correlate with IVH. As central nervous tissue, the preterm retina and brain may reflect similar disease processes. These findings support increased vascular and blood-retinal-barrier permeability models of CME, and demonstrate potential utility of OCT imaging for monitoring and predicting neurological disease and neurodevelopmental outcomes.
This is a 2020 ARVO Annual Meeting abstract.
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