Understanding Clinically Undetected Macular Changes in Early Retinopathy of Prematurity on Spectral Domain Optical Coherence Tomography
Understanding Clinically Undetected Macular Changes in Early Retinopathy of Prematurity on Spectral Domain Optical Coherence Tomography
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DOI：
10.1167/iovs.10-7155
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发表时间：
2011-07-01
影响因子：
4.4
通讯作者：
Shetty, Bhujang K.
中科院分区：
文献类型：
--
作者：
Vinekar, Anand;Avadhani, Kavitha;Shetty, Bhujang K.
目的.目的探讨急性早产儿视网膜病变（ROP）黄斑病变的临床意义。54名早产儿ROP和20名对照组进行了常规ROP筛查间接检眼镜和成像。将台式光谱域光学相干断层扫描（SD-OCT）扫描仪（Spectralis; Heidelberg Engineering，Heidelberg，德国）转换为手持式设备，用于在办公室中对无镇静的婴儿进行成像。在办公室的所有婴儿中获得SD-OCT图像。在SD-OCT上，79只患有2期ROP的眼睛中有23只（29.1%）显示异常中心凹变化，尽管临床上中心凹正常。在这23只眼睛中，观察到了2种不同的中心凹受累模式：“模式A”，其特征是圆顶形中心凹抬高和囊状空间，中间有高度反射的垂直隔膜，以及“模式B”，其特征是保留中心凹凹陷，视网膜内囊状空间较少。分别有12只（52.2%）和11只（47.8%）眼出现这些模式。所有属于1期ROP（27例）和正常组（40例）的眼睛（100%）均无异常SD-OCT变化。1期、2期和正常眼的平均中央凹厚度分别为156.9 +/- 28.3 μ m、206.5 +/- 98.7 μ m和135.9 +/- 17.6 μ m（P < 0.001）。23只眼中有19只在52周的月经后年龄（PMA）进行了系列成像，所有患者在这次访视时均显示中心凹轮廓正常化。轻度ROP中黄斑的SD-OCT变化先前尚未描述。我们的方法表明，婴儿可以在办公室仰卧和未麻醉的情况下成像。我们推测，这些短暂的中央凹的变化，在关键时刻的中心凹在早产儿可能会影响他们的视力在成年生活。（Invest Ophthalmol维斯科学。2011;52：5183-5188）DOI：10.1167/iovs.10-7155
PURPOSE. To investigate macular changes in acute retinopathy of prematurity (ROP).METHODS. Fifty-four premature infants with ROP and 20 controls underwent routine ROP screening with indirect ophthalmoscopy and imaging. A tabletop spectral domain optical coherence tomography (SD-OCT) scanner (Spectralis; Heidelberg Engineering, Heidelberg, Germany) was converted into a handheld device to image infants in the office sans sedation.RESULTS. SD-OCT images were obtained in all infants in the office. On SD-OCT, 23 of 79 eyes (29.1%) with stage 2 ROP showed abnormal foveal changes despite clinically normal foveae. Of the 23 eyes, 2 distinct patterns of foveal involvement were observed: "pattern A," which was characterized by dome-shaped foveal elevation and cystoid spaces with highly reflective intervening vertical septae, and "pattern B," which was characterized by preservation of the foveal depression with fewer intraretinal cystoid spaces. These patterns were seen in 12 (52.2%) and 11 (47.8%) eyes, respectively. All eyes (100%) belonging to stage 1 ROP (27) and the normal group (40) had no abnormal SD-OCT changes. The mean central foveal thickness was 156.9 +/- 28.3 mu m, 206.5 +/- 98.7 mu m, and 135.9 +/- 17.6 mu m for stage 1, 2, and normal eyes, respectively (P < 0.001). Nineteen of the 23 eyes underwent serial imaging at 52 weeks' postmenstrual age (PMA), and all of them revealed normalization of foveal contours at this visit.CONCLUSIONS. SD-OCT changes of the macula in mild ROP have not been previously described. Our method reveals that infants may be imaged supine and unanesthetized in the office. We hypothesize that these transient foveal changes at the critical time of fovealization in premature infants may influence their visual acuity in the adult life. (Invest Ophthalmol Vis Sci. 2011;52:5183-5188) DOI:10.1167/iovs.10-7155