Choroid Development and Feasibility of Choroidal Imaging in the Preterm and Term Infants Utilizing SD-OCT

Abstract

PURPOSE. To determine whether choroidal imaging is feasible in preterm and term infants using an 840-nm portable spectral domain optical coherence tomography (SD-OCT) system without the use of enhanced-depth imaging techniques and to assess choroidal development by comparing choroidal thickness of preterm infants, term infants, and adults.METHODS. SD-OCT images were obtained from 86 preterm infants, 59 term infants, and nine adults using a portable SD-OCT system plus nine adults using a tabletop system. An unprocessed image across the macula from one randomly selected eye of each participant was selected for determination of whether the choroidal-scleral junction (CSJ) could be visualized and for measurement of choroidal thickness.RESULTS. Subfoveal CSJ was visualized in 96% of young-preterm infants (imaged from 30-36 weeks postmenstrual age [PMA]); 78% of term-aged preterm infants (imaged from 37-42 weeks PMA); 49% of term infants; and 39% of adult subjects. Racial pigmentation did not affect CSJ visibility in young-preterm infants (P ¼ 0.57). Subfoveal choroidal thickness (SFCT) in young-preterm infants, term-aged preterm infants, term infants, and adults was 176 6 53 lm, 289 6 92 lm, 329 6 66 lm, and 258 6 66 lm, respectively, and these were all statistically significantly different from one another except term-aged preterms to adults.CONCLUSIONS. Infant choroid can be imaged with a portable SD-OCT system without enhanced depth imaging. Melanin in the RPE and choroid does not hinder outer choroidal imaging in young-preterm infants without advanced retinopathy of prematurity (ROP). In preterm infants, choroidal thickness increased with age but was thinner when compared to term infants suggesting delayed development due to ROP.

Reproducibility of circumpapillary retinal nerve fiber layer measurements using handheld optical coherence tomography in sedated children

“…The development of a handheld SD-OCT has enabled pediatric practitioners to acquire high resolution images of the circumpapillary RNFL and macula in neonates, infants and young children. [13][14][15][16][17][18][19][20][21][22][23][24] While neonates and infants can be imaged while awake, the portability of the handheld OCT permits acquisition in toddlers and young children during sedation.…”

Handheld simultaneous scanning laser ophthalmoscopy and optical coherence tomography system

“…The use of this technology will provide a compact and cost-effective solution for high SNR, motion-corrected imaging of patients that are supine, under anesthesia, or unable to position. These include infants with variety of retinal diseases such as retinopathy of prematurity [12, 35,36] albinism [37], nystagmus [38], Shaken baby syndrome [15], and for imaging young children.…”

Evaluation of Choroidal Thickness and Retinal Pigmented Epithelium using Cirrus SD-OCT in Portuguese Children with history of Preterm birth

“…11 Robb showed the ability of RPE to stimulate choroidal vasculature development. 12 Other study that corroborates the relevance of RPE in choroid development, revealed absence of choriocapillaris in absence of VEGF expression by RPE.…”

“…After exposure to lower oxygen levels, choroidal vasculature continues to develop, and the choroid becomes thicker and closer to choroid of normal infants. 11 Lower expression of VEGF RPE and high levels of oxygen could be the reason for a thinner choroid in patients with ROP comparing with preterm children.…”