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Shwetha Mangalesh, Brendan McGeehan, Vincent Tai, Xi Chen, Maureen Maguire, Cynthia Toth; Optical Coherence Tomography (OCT) Characteristics and Prevalence at 35-37 weeks Postmenstrual Age in a Cohort of Very Preterm Infants. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2185.
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© ARVO (1962-2015); The Authors (2016-present)
We have limited knowledge of the association of the subclincial developing retinal microanatomy and retinopathy of prematurity (ROP) in very preterm infants. Our objective is to identify relationships between microanatomical retinal features and ROP.
Infants were enrolled in BabySTEPS (STudy of Eye imaging in Premature infantS) if they met eligibility criteria for ROP screening and the parent provided informed consent. We captured high-speed, hand-held swept source OCT (SSOCT) imaging of both eyes using an investigational bedside system at the time of clinical ROP exams. For this cross-sectional analysis, we included untreated eyes of infants imaged at 35-37 weeks postmenstrual age (PMA). Masked graders extracted qualitative and quantitative SSOCT features. Analyses of associations between these features and clinical ROP data accounted for use of both eyes of infants.
Of 129 eyes in 65 infants, 66 (51%) had ROP stage 0, 24 (19%) 1, 36 (28%) 2, and 3 (2%) 3. Nine (7%) eyes had either pre-plus or plus disease. Macular edema (ME) was present in 64% of eyes (mild 28%, moderate 19%, severe 17%, ungradable 2%) (Fig 1) and bilateral in 78% of infants with any ME. With increase in ROP stage from 0 to 2, mean (standard deviation, SD) central foveal thickness (CFT) increased from 212(119) to 298(87)µm (p<0.001), prevalence of ME increased from (47% to 78%, p=0.02), and choroidal thickness decreased from 237 (72) to 197 (70) (p=0.06). The choroid was thinner with pre-plus or plus disease (151(59)µm) vs without (233 (76)µm, p=0.002), while the retina did not vary. (Table 1)
ME was associated with higher stages of ROP from 0 to 2, but did not vary with pre-plus/plus disease. Choroidal thinning, in contrast, was associated with pre-plus/plus disease, but not definitively with stage. These findings may reflect different injury mechanisms in ROP and will be examined further in the longitudinal analysis of these infants.
This is a 2020 ARVO Annual Meeting abstract.
Fig 1: B-scans and retinal thickness maps of ME severity in Stage 2 ROP; fovea (F): (a) None; (b) Mild: little to no deformation of the foveal contour; (c) moderate: flattening or slight upward bulging of the fovea (d) severe: severe upward bulging of the foveal contour. Mean (SD) CFT increased from 158(37)µm without ME to 440(63)µm with severe ME (p< 0.001).
Table 1: SSOCT features by ROP stage and plus disease
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