Macular OCT Characteristics at 36 Weeks’ Postmenstrual Age in Infants Examined for Retinopathy of Prematurity

Mangalesh, Shwetha; McGeehan, Brendan; Tai, Vincent; Chen, Xi; Tran-Viet, Du; Vajzovic, Lejla; Viehland, Christian; Izatt, Joseph A.; Cotten, C. Michael; Freedman, Sharon F.; Maguire, Maureen G.; Toth, Cynthia A.

doi:10.1016/j.oret.2020.09.004

Cited by 37 publications

(62 citation statements)

References 34 publications

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“…The study adhered to the guidelines of Health Insurance Portability and Accountability Act and the tenets of the Declaration of Helsinki. The BabySTEPS enrollment, image capture, and reproducibility have been reported previously 21 and are summarized in brief here.…”

Section: Methodsmentioning

confidence: 99%

“…Birth weight percentiles were calculated from their recorded birth weight in grams and gestational age at birth using the PediTools Growth Parameters online calculator according to the revised Fenton preterm growth charts. 21 – 23 …”

Section: Methodsmentioning

confidence: 99%

“…In this study, we used handheld OCT devices to obtain serial images of the macula in a large cohort of premature infants undergoing ROP screening. 21 The depth of the foveal pit was quantified, and inner versus outer retinal layer thickness measured in segmented images. We found that infants born at younger gestational ages had shallower foveal pits compared to later born infants throughout their nursery course, explained in large part by thicker inner retinal layers at the foveal center.…”

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confidence: 99%

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Foveal Differentiation and Inner Retinal Displacement Are Arrested in Extremely Premature Infants

O’Sullivan

Ying

Mangalesh

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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Purpose Children with a history of prematurity often have poorly developed foveae but when during development foveal differences arise. We hypothesize that the course of foveal development is altered from the time of preterm birth. Methods Eyes of 102 preterm infants undergoing retinopathy of prematurity screening examinations in the STudy of Eye imaging in Premature infantS (BabySTEPS) (NCT02887157) were serially imaged between 30 and 42 weeks postmenstrual age (PMA) using handheld optical coherence tomography systems. Total retinal thickness, inner retinal layer (IRL) thickness, and outer retinal layer (ORL) thickness were measured at the foveal center and parafovea. Foveal put depth, IRL thickness, and ORL thickness were compared between infants born at different gestational ages using mixed effects models. Results Foveal pit depth and IRL thickness were inversely related to gestational age; on average, the most premature infants had the thickest IRL and shallowest pits at all PMAs. Differences were evident by 30 weeks PMA and persisted through 42 weeks PMA. The foveal pits of the most premature infants did not progressively deepen, and the IRLs did not continue to thin with increasing chronological age. Conclusions Foveation in extremely preterm infants is arrested from the earliest observed ages and fails to progress through term equivalent age. The developmental displacement of the IRL from the foveal center into the parafovea does not occur normally after preterm birth. These observations suggest that foveal hypoplasia seen in children with history of prematurity is due to disturbances in foveal development that manifest within weeks of birth.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Foveal Differentiation and Inner Retinal Displacement Are Arrested in Extremely Premature Infants

O’Sullivan

Ying

Mangalesh

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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“…As there is a high frequency of macular edema in preterm infants and the macular edema is almost exclusively present in the INL, 22 – 25 we first assessed if reference for the ICP/DCP boundary is better based on the IPL/INL or OPL/ONL junction. Following offset parameter optimization, we determined either 17.48 µm below the IPL/INL junction or 34.96 µm above the OPL/ONL junction as potential offsets for the ICP/DCP boundary.…”

Section: Resultsmentioning

confidence: 99%

“…The high frequency of macular edema, as evident by cystoid spaces predominantly located in the INL, presents a unique challenge in determining the segmentation between ICP and DCP in preterm infants. [22][23][24][25] We assessed both the IPL/INL junction and OPL/ONL junction as reference boundaries for segmentation of the ICP and DCP. When macular edema was not present, the vascular pattern of ICP and DCP was similar, irrespective of IPL or OPL as the reference boundary of choice.…”

Section: Discussionmentioning

confidence: 99%

Depth-Resolved Visualization of Perifoveal Retinal Vasculature in Preterm Infants Using Handheld Optical Coherence Tomography Angiography

Patel

Imperio

Viehland

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose To establish methods to visualize depth-resolved perifoveal retinal vasculature in preterm infants using handheld optical coherence tomography angiography (OCT-A). Methods In this exploratory study, eyes of preterm infants were imaged using an investigational noncontact, handheld swept-source OCT-A device as part of the prospective BabySTEPS infant retinal imaging study. We selected high-quality OCT-A volumes at two developmental stages for analysis. Customized MATLAB scripts were used to segment retinal layers, test offset parameters, and generate depth-resolved OCT-A slabs. The superficial (SCP), intermediate (ICP), and deep (DCP) capillary plexuses were visualized and qualitatively assessed by three image graders. Results Six eyes from six preterm infants were included in this analysis. A three-layered perifoveal retinal vasculature was successfully visualized in all three eyes (three infants) in the 40 weeks postmenstrual age (PMA) group (one of three eyes with treated type 1 retinopathy of prematurity [ROP]). No obvious ICP or DCP was found in good-quality scans of the three eyes (three infants) in the 35 weeks PMA group (three of three eyes developed type 1 ROP). Conclusions Custom segmentation parameters are useful to visualize perifoveal retinal vasculature in preterm infants. At term age, a three-layered capillary structure is visible in most eyes, while prior to detectable flow within the ICP and DCP, the perifoveal vasculature may be better visualized in two layers. Translational Relevance Development of segmentation parameters for depth-resolved OCT-A of perifoveal retinal vasculature in preterm infants facilitates the study of human retinal vascular development and vascular pathologies of ROP.

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Preterm Infant Stress During Handheld Optical Coherence Tomography vs Binocular Indirect Ophthalmoscopy Examination for Retinopathy of Prematurity

et al. 2021

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urvival and neurodevelopmental outcomes in preterm infants, including periviable infants (22-25 weeks' gestational age), have improved over the past 20 years. However, despite these achievements, long-term neurodevelopmental outcomes for these infants remain a concern. [1][2][3] Prolonged exposure to early-life stress while in the intensive care nursery (ICN) causes alterations in the neural connectome leading to cognitive deficits later in life. [4][5][6] Stressors in the ICN include physiological stressors such as sepsis, environmental stressors such as excessive light, and experiential stressors such as blood draws. 4,7,8 Retinopathy of prematurity (ROP) examination by a trained ophthalmologist usually entails placement of an eyelid speculum, mydriatic drops, retinal illumination by the bright light of a binocular indirect ophthalmoscope, and pressure on the outer surface of the eye. 9 Binocular indirect ophthalmoscopy (BIO) is a repeated experiential stressor/ painful procedure for infants [10][11][12][13] and can produce changes in heart rate, both tachycardia and bradycardia, and apnea during and after examination. 11,14-16 Use of oral sucrose and intranasal fentanyl have been reported to reduce pain associated with retinal examination without increasing the risk of respiratory depression; however, their safety and efficacy need to be verified. 17,18 Approximately 70 000 infants per year in the United States receive 1 or more BIO examinations for ROP screening. 19IMPORTANCE Binocular indirect ophthalmoscopy (BIO) examination for retinopathy of prematurity (ROP) is a well-known cause of repeated preterm infant stress. OBJECTIVE To compare stress during investigational optical coherence tomography (OCT) imaging to that during BIO for ROP. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study examined infants at the bedside in the intensive care nursery. Consecutive preterm infants enrolled in Study of Eye Imaging in Preterm Infants (BabySTEPS) who had any research OCT imaging as part of the study. Patients were recruited from June to November 2019, and analysis began April 2020. MAIN OUTCOMES AND MEASURES Infant stress was measured using modified components of a neonatal pain assessment tool before (baseline) and during OCT imaging and BIO examination of each eye. RESULTS For 71 eye examinations of 16 infants (mean [SD] gestational age, 27 [3] weeks; birth weight, 869 [277] g), change from baseline to each eye examination was lower during OCT imaging than during BIO and the difference between OCT imaging and BIO at each eye examination was significant for the following: infant cry score (first eye examination: mean [SD], 0.03 [0.

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Macular OCT Characteristics at 36 Weeks’ Postmenstrual Age in Infants Examined for Retinopathy of Prematurity

Cited by 37 publications

References 34 publications

Foveal Differentiation and Inner Retinal Displacement Are Arrested in Extremely Premature Infants

Foveal Differentiation and Inner Retinal Displacement Are Arrested in Extremely Premature Infants

Depth-Resolved Visualization of Perifoveal Retinal Vasculature in Preterm Infants Using Handheld Optical Coherence Tomography Angiography

Preterm Infant Stress During Handheld Optical Coherence Tomography vs Binocular Indirect Ophthalmoscopy Examination for Retinopathy of Prematurity

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