Arm-mounted optical coherence tomography angiography in extremely low birth weight neonates with retinopathy of prematurity.
Arm-mounted optical coherence tomography angiography in extremely low birth weight neonates with retinopathy of prematurity.
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DOI：
10.1016/j.ajoc.2020.100624
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发表时间：
2020-06-01
影响因子：
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通讯作者：
Tsui, Irena
中科院分区：
文献类型：
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作者：
Kothari, Nikisha;Chu, Alison;Tsui, Irena
目的：评估使用臂上光学相干断层扫描血管造影（OCTA）设备对出生体重小于1000g或小于27周的极低出生体重儿（定义为出生体重小于1000g或小于27周胎龄的婴儿）进行成像的可行性。方法：在一个单一地点的住院患者学术中心进行横断面病例系列。研究对象包括早产儿和符合ROP筛查标准的婴儿。收集出生史，如胎龄和出生体重。在ROP筛查和治疗期间，受试者采用仰卧位OCTA成像。人工校正节段误差，并从浅、深毛细血管丛（SCP， DCP）层计算FAZ面积。主要观察指标为中央凹无血管区（FAZ）面积、ROP分期及治疗情况。结果：7例ELBW患儿，成像时平均胎龄为25周（范围23-4/7至26周），平均经后年龄为54.7周（范围43-80周）。平均出生体重为615克（范围500-680克）。13只眼采用原发性激光、延迟激光抗血管内皮生长因子注射和巩膜扣环治疗。6名婴儿在全身麻醉下成像，1名婴儿在未镇静的情况下成像。慢性阻塞性肺病的平均FAZ面积为0.17mm2（范围为0.03mm2-0.37mm2），慢性阻塞性肺病的平均FAZ面积为0.04mm2（范围为0mm2-0.09mm2）。在SCP和DCP中，FAZ面积与视网膜外层厚度与视网膜内层厚度之比呈正相关（r2=0.48, p=0.02; r2=0.46, p=0.02），与SCP中视网膜内层厚度呈负相关（r2=0.56, p=0.008）。结论和重要性：臂载OCTA在ELBW婴儿中是可行的，并提供了有关中央窝发育的信息。利用这种方法测量FAZ面积和视网膜厚度可用于研究ELBW、周围ROP和ROP治疗对中央凹发育的影响。
PURPOSE: To assess the feasibility of imaging extremely low birth weight infants, defined as infants born weighing less than 1000g or before 27 weeks of gestational age, with an arm-mounted optical coherence tomography angiography (OCTA) device.METHODS: Cross-sectional case series conducted at a single site in-patient academic center. Subjects included infants who had been born premature and met ROP screening criteria. Birth history such as gestational age and birth weight were collected. Subjects were imaged with OCTA in a supine position during ROP screening and treatment. Segmental errors were manually corrected and FAZ area was calculated from the superficial and deep capillary plexus (SCP, DCP) layers. Main outcomes measures were foveal avascular zone (FAZ) area, ROP stage and treatment.RESULTS: Seven ELBW infants were included with an average gestational age of 25 weeks (range=23-4/7 to 26 weeks) and average postmenstrual age of 54.7 weeks (range=43-80 weeks) at the time of imaging. Average birth weight was 615g (range 500-680 grams). Thirteen eyes had ROP treatment including primary laser, anti-vascular endothelial growth factor injection with delayed laser, and scleral buckle. Six infants were imaged under general anesthesia and one infant was imaged without sedation. Average FAZ area was 0.17mm2 (range=0.03mm2-0.37mm2) in the SCP and 0.04mm2 (range 0mm2-0.09mm2) in the DCP. FAZ area correlated positively to the ratio of outer retinal layer thickness to inner retinal layer thickness at the foveal center in the SCP and DCP (r2=0.48, p=0.02; r2=0.46, p=0.02) and negatively with inner retinal layer thickness in the SCP (r2=0.56, p=0.008).CONCLUSIONS AND IMPORTANCE: Arm-mounted OCTA was feasible in ELBW infants and provided information about the developing fovea. Measurement of FAZ area and retinal thickness using this modality may be used to study the effects of ELBW, peripheral ROP and ROP treatment on foveal development.