Foveal Development in Infants Treated with Bevacizumab or Laser Photocoagulation for Retinopathy of Prematurity

Vogel, Ryan N.; Strampe, Margaret R.; Fagbemi, Oladipo E.; Visotcky, Alexis; Tarima, Sergey; Carroll, Joseph; Costakos, Deborah M.

doi:10.1016/j.ophtha.2017.09.020

Cited by 43 publications

(43 citation statements)

References 44 publications

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“…A possible explanation for this difference in measured displacement could be that part of the GCL/IPL extrusion from FC has already occurred during normal foveal development [24] before the start of developmental arrest is induced by the premature birth. Evidence in line with this explanation has been presented in a longitudinal OCT study of preterms indicating that the extrusion of IRL is sequential with GCL/ IPL disappearing before INL during the early phase after premature birth [25]. Another explanation for the difference in retardation within each immaturity group could be that the horizontal traction forces postulated to act during normal development [22] are differently blocked to some extent.…”

Section: Discussionmentioning

confidence: 81%

Structural consequences of arrested foveal development in preterms with persisting signs of immaturity

Sjöstrand

Popovic

2019

Eye

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Purpose To evaluate the impact of structural changes in a limited sample of adult preterms with foveal immaturity from optical coherence tomography (OCT) B-scan images and to estimate layer displacement and changes in areal and volume magnification within the inner fovea. Subjects and methods Layer thickness was measured in conventional and directional OCT scans from eight preterms with different degrees of foveal immaturity (24-33 weeks of gestation, 22-33 years of age) and five controls (20-33 years of age). We obtained reflectivity profiles of the outer plexiform layer (OPL) and manual segmentation data of the inner nuclear layer (INL) and the combined ganglion cell layer (GCL) and inner plexiform layer (IPL) at specified eccentricities from 300 to 900 µm. Displacement of cumulative thickness curves of preterms compared with that of the controls was used to estimate retardation of layer displacement. Changes in areal magnification and layer thickness were used to construct a structural model of redistribution within the fovea of preterms. Results Retardation of centrifugal layer displacement of OPL and all inner retinal layers (IRL) was marked in both preterm groups with foveal immaturity, whereas retardation was marginal in the preterm group without clinical signs of immaturity. Retarded displacement within the IRL and OPL had a major impact on available space within the central fovea.Conclusions A marked retardation of displacement was demonstrated for all IRL within the immature fovea of preterms with decreased areal and volume magnification and reduced space available for synaptic communication coupled to the degree of immaturity.

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Section: Discussionmentioning

confidence: 81%

Structural consequences of arrested foveal development in preterms with persisting signs of immaturity

Sjöstrand

Popovic

2019

Eye

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“…Because VEGF plays an important role in many physiological processes, differences in VEGF expression could explain the differences seen in foveal development. 4 Note that, in the parafoveal and foveal area, there was no statistical difference for VLD and PD between the two groups. The variations of VLD and PD in the central foveal are most obvious.…”

Section: Discussionmentioning

confidence: 84%

“…We observed that eyes with LP exhibited smaller FAZ and greater CFT than that with IVR ( table 1 , figure 2 ), which is consistent with the previous study. 16 Vogel et al 4 reported that LP was associated with extrusion of the inner retinal layers. The LP leads to the destruction of the avascular retina which prevents the peripheral migration and reorganisation of inner retinal cells, whereas the inner retinal cells in the IVR-treated eyes continue to migrate.…”

Section: Discussionmentioning

confidence: 99%

“… 3 There are two main treatment methods for ROP currently: antivascular endothelial growth factor (VEGF) treatment and laser photocoagulation (LP). Previous researchers have studied patients’ foveal development after intravitreal injection of ranibizumab (IVR) and/or LP using optical coherence tomography (OCT), 4–7 while other researchers studied the foveal microvascular structure using fundus fluorescein angiograms (FFA). 8 The OCT angiography (OCTA) provides a new technique to visualise the retinal vasculature with minimal risk and no-invasion.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of OCT angiography in children with a history of intravitreal injection of ranibizumab versus laser photocoagulation for retinopathy of prematurity

Zhao

Lam

et al. 2020

Br J Ophthalmol

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PurposeTo compare the foveal microvascular structure characteristics in children with a history of intravitreal injection of ranibizumab (IVR) versus laser photocoagulation (LP) for retinopathy of prematurity by optical coherence tomography angiography (OCTA).MethodsIn this cross-sectional study, a total of 17 children (28 eyes) underwent IVR and 20 children (37 eyes) underwent LP were recruited. The age of doing OCTA examination of the two groups are 5.4±1.1 years and 6.3±1.8 years, respectively (p=0.07). Spectral-domain OCTA was performed for all the eyes with a scan size of 3×3 mm. The data of the superficial retinal layer were analysed. The foveal avascular zone (FAZ) and vessel density (including vessel length density (VLD) and perfusion density (PD)) were measured using the software of OCTA (Cirrus AngioPlex 5000, Carl Zeiss, Meditec, Dubin, California, USA). The central foveal thicknesses (CFT) were measured by cross-sectional OCT.ResultsIn the central fovea, the retinal VLD and PD of patients with IVR were 13.82±2.99 mm/mm2 and 0.25±0.05 mm2/mm2, respectively, which were significantly lower than those of the LP group (15.64±2.71 mm/mm2 and 0.28±0.05 mm2/mm2, p=0.01 and p=0.006). The FAZ area of patients with IVR and LP were 0.13±0.09 mm2 and 0.09±0.07 mm2, respectively (p=0.048). The CFT of patients with IVR and LP were 200.7±16.7 µm and 220.9±22.7 µm, respectively (p<0.01). The logarithm of the minimal angle of resolution best-corrected visual acuity of patients with IVR and LP were 0.2±0.1 and 0.1±0.1, respectively (p=0.01). There was no significant difference in the parafoveal and foveal VLD and PD, FAZ morphological index and spherical equivalent refraction (SER) between the two groups.ConclusionThe IVR might contribute to microvascular changes in the macular zone, such as reducing the central foveal VLD and PD, while the LP might contribute to microstructural changes, such as smaller FAZ and thicker CFT.

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“…Studies are now emerging that use HH-OCT to chart foveal changes in prematurity, for example, to compare the effect of treatments for ROP. 4 Earlier HH-OCT studies in preterm infants report persistence of inner retinal layers across the foveal depression, increased thickness of the inner retina, shallow foveae, and reduced depth. 5 – 8 However, because GA, BW, and ROP are all strongly correlated, the relationship between foveal changes observed on OCT with severity of prematurity and changes associated with ROP remains unclear.…”

mentioning

confidence: 97%

Potential Utility of Foveal Morphology in Preterm Infants Measured Using Hand-Held Optical Coherence Tomography in Retinopathy of Prematurity Screening

Anwar

Nath

Patel

et al. 2020

Retina

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Purpose: To investigate dynamic foveal morphology with postmenstrual age, in preterm infants with and without retinopathy of prematurity using hand-held optical coherence tomography, adjusting for gestational age (GA) and birthweight (BW). Methods: Prospective mixed cross-sectional/longitudinal observational study of 87 participants (23-36 weeks GA; n = 30 with, n = 57 without retinopathy of prematurity) using hand-held optical coherence tomography images (n = 278) acquired between 31 weeks and 44 weeks postmenstrual age excluding treated retinopathy of prematurity. Measurements included foveal width, area, depth, central foveal thickness, maximum slope, and parafoveal retinal thickness at 1,000 mm nasal and temporal to the central fovea. Results: Retinopathy of prematurity was significantly correlated with only foveal width in either GA or BW adjusted statistical models. In contrast, severity of prematurity (GA, BW) correlated with foveal area (P , 0.005), depth (P # 0.001), and slope (P , 0.01), although central foveal thickness (P = 0.007) and parafoveal retinal thickness (P , 0.001) correlated with GA, but not with BW. Conclusion: Foveal width is independent of GA and BW with potential in retinopathy of prematurity screening assessment using hand-held optical coherence tomography. Foveal morphology could be graded in prematurity during development, with possible implications for future management of preterm infants.

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Foveal Development in Infants Treated with Bevacizumab or Laser Photocoagulation for Retinopathy of Prematurity

Cited by 43 publications

References 44 publications

Structural consequences of arrested foveal development in preterms with persisting signs of immaturity

Structural consequences of arrested foveal development in preterms with persisting signs of immaturity

Comparison of OCT angiography in children with a history of intravitreal injection of ranibizumab versus laser photocoagulation for retinopathy of prematurity

Potential Utility of Foveal Morphology in Preterm Infants Measured Using Hand-Held Optical Coherence Tomography in Retinopathy of Prematurity Screening

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