Our large longitudinal cohort study has provided evidence that MPTSCPC is a safe and generally effective option in the treatment of POAG up to 12 months.

IMPORTANCE Handheld spectral-domain optical coherence tomography (SD-OCT) can provide insights into the complex interactions occurring at the vitreoretinal interface in retinopathy of prematurity (ROP) to enhance our understanding of ROP pathology. OBJECTIVE To characterize vitreous bands in premature infants with use of handheld SD-OCT. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study conducted from July 7, 2015, to February 28, 2017, at 2 university-based neonatal intensive care units. Seventy-three premature infants who required routine ROP screening examination were recruited. Informed consent was obtained from all legal guardians. Trained graders who were masked to the clinical assessment analyzed each SD-OCT scan of the right eye for vitreoretinal findings. A third trained grader mediated disagreements. MAIN OUTCOMES AND MEASURES Associations between the presence of vitreous bands in premature infants with ROP diagnoses and the presence of other vitreoretinal SD-OCT findings were investigated. RESULTS Of the 73 infants recruited, 6 infants' parents withdrew their children from the study, and 2 infants were too hemodynamically unstable for imaging, leaving a total of 65 participants. Of these, 32 (49%) were female, 36 (55%) were white, 10 (15%) were Hispanic, 3 (5%) were Native American, 4 (6%) were African American, 4 (7%) were Asian/Pacific Islander, and 8 (12%) were other. The mean (SD) gestational age was 28 (2.7) weeks, the mean (SD) birth weight was 997 g (286 g), and the mean (SD) postmenstrual age at imaging was 34 (3) weeks (mean [SD] total of 3 [2] imaging sessions). Comparing the 24 infants (37%) who had a right eye vitreous band at any time with the 41 (63%) who did not, no difference in mean birth weight, gestational age, postmenstrual age at imaging, sex, or race/ethnicity was identified. No associations with ROP stage (eg, in 6 [25%] infants with vitreous bands vs 4 [9.8%] in those without; P = .23), presence of plus disease (2 [8%] vs 2 [5%]; P = .84), or type 1 ROP (3 [12%] vs 3 [7%]; P = .66) were identified. Vitreous bands were associated with epiretinal membrane detected on SD-OCT (P = .001) with an odds ratio of 9.4 (95% CI, 2.8-31.3) in 15 [62%] infants with vitreous bands vs 6 [15%] in those without. Vitreous bands were also associated with cystoid macular edema (in 15 [62%] infants with vitreous bands vs 1 [27%] in those without; P = .005) with an odds ratio of 4.5 (95% CI, 1.5-13.3). CONCLUSIONS AND RELEVANCE In this study, the development of vitreous bands was associated with both cystoid macular edema and epiretinal membrane. These findings suggest a tractional pathogenesis to these entities among premature infants. This study did not find a direct association between vitreous bands and severe ROP. Additional study is needed to determine whether vitreous bands represent subclinical hyaloidal organization leading to retinal detachment in advanced ROP.

Objective: To evaluate the association between retinopathy of prematurity and vitreous findings in premature infants detected by handheld spectral-domain optical coherence tomography.Design: Prospective, observational cohort study.Participants: Consecutive sample of 92 premature infants requiring retinopathy of prematurity screening at two academic neonatal intensive care units, between July 2015 and March 2018. Methods:Infants underwent handheld spectral domain optical coherence tomography at the time of routine retinopathy of prematurity examinations. Two masked, trained graders analyzed right eye vitreoretinal findings including semi-automated quantification of punctate hyperreflective vitreous opacities within 5 foveal/parafoveal B-scans (Vitreous Opacity Ratio). Main Outcome Measures:Excluding post-treatment data, vitreous findings were compared to clinical retinopathy of prematurity diagnoses.Results: Agreement between image graders for all vitreoretinal findings was 91% (kappa=0.86 [95% confidence interval, 0.82-0.90], P<0.001). Among 92 infants undergoing 280 imaging sessions (52% male, mean gestational age 28.3±2.8 weeks, mean birthweight 1014.5±285.0 grams), 36/92 (39%) developed retinopathy of prematurity. Punctate hyperreflective vitreous opacities were identified in 61/92 (66%) infants. The presence of punctate hyperreflective vitreous opacities at least once was associated with a diagnosis of retinopathy of prematurity (62% vs. 29% without opacities, P=0.003), maximum retinopathy of prematurity stage (P=0.001), pre-plus or plus disease (24% vs. 5%, P=0.005), and type 1 disease (14% vs. 2%, P=0.03).

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