In Vivo Foveal Development Using Optical Coherence Tomography
In Vivo Foveal Development Using Optical Coherence Tomography
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DOI：
10.1167/iovs.15-16542
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发表时间：
2015-07-01
影响因子：
4.4
通讯作者：
Gottlob, Irene
中科院分区：
文献类型：
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作者：
Lee, Helena;Purohit, Ravi;Gottlob, Irene
目的.采用手持式光谱域光学相干断层扫描（HH-SDOCT）技术，研究足月儿和幼儿正常中心凹发育的时间进程。我们对261名婴儿、儿童和年轻人进行了534次HH-SDOCT扫描，平均年龄为4.9岁（范围：0-27岁）。每个视网膜层在ImageJ中手动分割，并与胎龄（GA）和视力（VA）相关。使用分数多项式模型计算每个视网膜层在中心凹、旁中心凹和中心凹周围的发育轨迹。黄斑中心厚度（CMT）在出生至48.6个月GA之间呈递增趋势。视网膜中央凹神经节细胞（GCL）、内丛状层、内核层（INL）和外丛状层的厚度呈指数下降，直至18个月GA。有趣的是，大脑旁和中央凹周围GCL和INL厚度最初降低，直到17个月GA，然后增加厚度，直到65.5 GA。视网膜中央凹外核层、内节和外节的光感受器的厚度逐渐增加，直到GA分别为32.4、26.9和45.3个月。直到146个月GA，视网膜旁和中央凹周围的外视网膜层厚度逐渐增加。视网膜外层厚度和CMT与视力呈显著正相关，相关系数分别为r = 0.54（P < 0.0001）和r = 0.52（P < 0.0001）。我们第一次模拟了视网膜各层复杂的非线性发育轨迹，并证明了发育一直持续到青春期。我们对正常发育的描述将有助于诊断、监测和了解儿童视网膜疾病。
PURPOSE. To characterize the time course of normal foveal development in vivo in term infants and young children using handheld spectral-domain optical coherence tomography (HH-SDOCT).METHODS. We obtained 534 HH-SDOCT scans from 261 infants, children, and young adults with a mean age of 4.9 years (range, 0-27 years). Each retinal layer was manually segmented in ImageJ and correlated with gestational age (GA) and visual acuity (VA). The developmental trajectories of each retinal layer at the fovea, parafovea, and perifovea were calculated using fractional polynomial modeling.RESULTS. The central macular thickness (CMT) increases logarithmically between birth and 48.6 months GA. The foveal ganglion cell (GCL), inner plexiform, inner nuclear (INL), and outer plexiform layers decrease in thickness exponentially until 18 months GA. Interestingly, the parafoveal and perifoveal GCL and INL thicknesses initially decrease until 17 months GA and then increase in thickness until 65.5 GA. The foveal outer nuclear layer, inner segment, and outer segment of the photoreceptors increase in thickness logarithmically until 32.4, 26.9, and 45.3 months GA, respectively. The parafoveal and perifoveal outer retinal layers increase in thickness more gradually until 146 months GA. The thickness of the outer retinal layers and CMT were strongly correlated with VA, with r = 0.54 (P < 0.0001) and r = 0.52 (P < 0.0001), respectively.CONCLUSIONS. We have modeled for the first time the complex, nonlinear developmental trajectories for each retinal layer and demonstrate that development continues until adolescence. Our description of normal development will be helpful in diagnosing, monitoring, and understanding pediatric retinal disease.