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Comparison of foveal optical coherence tomography angiography findings between premature children with ROP and non-premature healthy children

Eye volume 35, pages 1721–1729 (2021)Cite this article

Subjects

Abstract

Purpose

Our aim is to compare foveal microvascular structure, foveal retinal thickness, and best-corrected visual acuity (BCVA) in children with a history of premature retinopathy (ROP) and healthy children. It is also evaluated whether microvascular structural changes in the course of ROP had resulted from treatment modalities of ROP or the disease itself.

Methods

This is a cross-sectional observational comparative study. Seventy-one children were analyzed in four different groups: children treated with bevacizumab (18), or laser (19) for ROP; or spontaneously regressed disease (18) and non-premature healthy children (16). We analyzed foveal avascular zone (FAZ) and vessel densities (VDs) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at foveal and parafoveal region with optical coherence tomography angiography (OCT-A). Foveal thickness was measured by cross-sectional OCT. Correlations between FAZ area, foveal VD, central foveal thickness (CFT), BCVA, gestational age (GA), and birth weight (BW) were evaluated.

Results

After comparing of OCT-A parameters between all premature children (groups 1–3) and non-premature children (group 4), significant differences were found in VD-SCP (whole), VD-SCP (foveal), VD-SCP (parafoveal), CFT, and VD-DCP (foveal) (all p < 0.001). Significantly smaller FAZ area was also noted in ROP children. Higher foveal VD of SCP, DCP, and smaller FAZ area were significantly associated with lower GA and BW.

Conclusion

By using OCT-A, significant foveal microvascular anomalies were identified in children with ROP irrespective of the treatment option or spontaneous regression. There has been a correlation between microvascular anomalies, CFT, and a lower BCVA.

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Fig. 1
Fig. 2: Correlation of GA and BW with foveal VD-SCP, VD-DCP and FAZ.
Fig. 3

References

  1. Leng Y, Huang W, Ren G, Cai C, Tan Q, Liang Y, et al. The treatment and risk factors of retinopathy of prematurity in neonatal intensive care units. BMC Ophthalmol. 2018;18:301. https://doi.org/10.1186/s12886-018-0973-1.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hellström A, Smith LE, Dammann O. Retinopathy of prematurity. Lancet. 2013;382:1445–57.

    Article  Google Scholar 

  3. Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminary results. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Arch Ophthalmol. 1988;106:471–9.

    Article  Google Scholar 

  4. Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121:1684–94.

    Article  Google Scholar 

  5. Wu WC, Kuo HK, Yeh PT, Yang CM, Lai CC, Chen SN. An updated study of the use of bevacizumab in the treatment of patients with prethreshold retinopathy of prematurity in taiwan. Am J Ophthalmol. 2013;155:150–8.

    CAS  Article  Google Scholar 

  6. Hwang CK, Hubbard GB, Hutchinson AK, Lambert SR. Outcomes after intravitreal bevacizumab versus laser photocoagulation for retinopathy of prematurity: a 5-year retrospective analysis. Ophthalmology. 2015;122:1008–15.

    Article  Google Scholar 

  7. Erol MK, Ozdemir O, Turgut Coban D, Bilgin AB, Dogan B, Sogutlu Sari E, et al. Macular findings obtained by spectral domain optical coherence tomography in retinopathy of prematurity. J Ophthalmol. 2014;2014:468653. https://doi.org/10.1155/2014/468653.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Villegas VM, Capó H, Cavuoto K, McKeown CA, Berrocal AM. Foveal structure-function correlation in children with history of retinopathy of prematurity. Am J Ophthalmol. 2014;158:508–12.

    Article  Google Scholar 

  9. Yeo JH, Chung H, Kim JT. Swept-source optical coherence tomography angiography according to the type of choroidal neovascularization. J Clin Med. 2019;8:1272.

    CAS  Article  Google Scholar 

  10. Lee WD, Devarajan K, Chua J, Schmetterer L, Mehta JS, Ang M. Optical coherence tomography angiography for the anterior segment. Eye Vis. 2019;6:4.

    Article  Google Scholar 

  11. Park JJ, Soetikno BT, Fawzi AA. Characterization of the middle capillary plexus using optical coherence tomography angiography in healthy and diabetic eyes. Retina. 2016;36:2039–50.

    CAS  Article  Google Scholar 

  12. Ashraf M, Nesper PL, Jampol LM, Yu F, Fawzi AA. Statistical model of optical coherence tomography angiography parameters that correlate with severity of diabetic retinopathy. Investig Ophthalmol Vis Sci. 2018;59:4292–8.

    CAS  Article  Google Scholar 

  13. You QS, Wang J, Guo Y, Flaxel CJ, Hwang TS, Huang D, et al. Detection of reduced retinal vessel density in eyes with geographic atrophy secondary to age-related macular degeneration using projection-resolved optical coherence tomography angiography. Am J Ophthalmol. 2019;S0002-9394:30461–1. https://doi.org/10.1016/j.ajo.2019.09.004.

    Article  Google Scholar 

  14. Mintz-Hittner HA, Knight-Nanan DM, Satriano DR, Kretzer FL. A small foveal avascular zone may be an historic mark of prematurity. Ophthalmology. 1999;106:1409–13.

    CAS  Article  Google Scholar 

  15. Nonobe N, Kaneko H, Ito Y, Takayama K, Kataoka K, Tsunekawa T, et al. Optical coherence tomography angiography of the foveal avascular zone in children with a history of treatment requiring retinopathy of prematurity. Retina. 2019;39:111–7.

    Article  Google Scholar 

  16. Takagi M, Maruko I, Yamaguchi A, Kakehashi M, Hasegawa T, Iida T. Foveal abnormalities determined by optical coherence tomography angiography in children with history of retinopathy of prematurity. Eye. 2019;33:1890–6.

    Article  Google Scholar 

  17. Chen YC, Chen YT, Chen SN. Foveal microvascular anomalies on optical coherence tomography angiography and the correlation with foveal thickness and visual acuity in retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol. 2019;257:23–30.

    CAS  Article  Google Scholar 

  18. Section on Ophthalmology American Academy of Pediatrics, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2006;117:572–6.

    Article  Google Scholar 

  19. Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121:1684–94.

    Article  Google Scholar 

  20. Lee YS, See LC, Chang SH, Wang NK, Hwang YS, Lai CC, et al. Macular structures, optical components, and visual acuity in preschool children after intravitreal bevacizumab or laser treatment. Am J Ophthalmol. 2018;192:20–30.

    Article  Google Scholar 

  21. Engerman RL. Development of the macular circulation. Investig Ophthalmol Vis Sci. 1976;15:835–40.

    CAS  Google Scholar 

  22. Böhm MR, Hodes F, Brockhaus K, Hummel S, Schlatt S, Melkonyan H, et al. Is angiostatin involved in physiological foveal avascularity? Investig Ophthalmol Vis Sci. 2016;57:4536–52.

    Article  Google Scholar 

  23. Lepore D, Quinn GE, Molle F, Baldascino A, Orazi L, Sammartino M, et al. Intravitreal bevacizumab versus laser treatment in type 1 retinopathy of prematurity: report on fluorescein angiographic findings. Ophthalmology. 2014;121:2212–9.

    Article  Google Scholar 

  24. Mansukhani SA, Hutchinson AK, Neustein R, Schetzer J, Allen JC, Hubbard GB. Fluorescein angiography in retinopathy of prematurity: comparison of infants treated with bevacizumab to those with spontaneous regression. Ophthalmol Retina. 2019;3:436–43.

    Article  Google Scholar 

  25. Falavarjani KG, Iafe NA, Velez FG, Schwartz SD, Sadda SR, Sarraf D, et al. Optical coherence tomography angiography of the fovea in children born preterm. Retina. 2017;37:2289–94.

    Article  Google Scholar 

  26. Miki A, Yamada Y, Nakamura M. The size of the foveal avascular zone is associated with foveal thickness and structure in premature children. J Ophthalmol. 2019;2019:8340729. https://doi.org/10.1155/2019/8340729.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Balasubramanian S, Borrelli E, Lonngi M, Velez F, Sarraf D, Sadda SR, et al. Visual function and optical coherence tomography angiography features in children born preterm. Retina. 2018. https://doi.org/10.1097/IAE.0000000000002301.

  28. Marmor MF, Choi SS, Zawadzki RJ, Werner JS. Visual insignificance of the foveal pit: reassessment of foveal hypoplasia as fovea plana. Arch Ophthalmol. 2008;126:907–13.

    Article  Google Scholar 

  29. Provis JM, Dubis AM, Maddess T, Carroll J. Adaptation of the central retina for high acuity vision: cones, the fovea and the avascular zone. Prog Retin Eye Res. 2013;35:63–81.

    Article  Google Scholar 

  30. Pakzad-Vaezi K, Keane PA, Cardoso JN, Egan C, Tufail A. Optical coherence tomography angiography of foveal hypoplasia. Br J Ophthalmol. 2017;101:985–8.

    Article  Google Scholar 

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Affiliations

  1. Ophthalmology Clinic, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Asli Vural & Bengi Demirayak

  2. Ophthalmology Clinic, Trabzon Fatih State Hospital, Trabzon, Turkey

    Murat Gunay

  3. Ophthalmology Clinic, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey

    Gökhan Celik & Osman Kizilay

Authors
  1. Asli Vural
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  2. Murat Gunay
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Correspondence to Asli Vural.

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Vural, A., Gunay, M., Celik, G. et al. Comparison of foveal optical coherence tomography angiography findings between premature children with ROP and non-premature healthy children. Eye 35, 1721–1729 (2021). https://doi.org/10.1038/s41433-020-01161-x

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