Spectral-Domain OCT Findings of Retinal Vascular-Avascular Junction in Infants with Retinopathy of Prematurity

Xi Chen, Shwetha Mangalesh, Alexandria Dandridge, Du Tran-Viet, David K. Wallace, Sharon F. Freedman, Cynthia A. Toth

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

PURPOSE: Bedside examination of premature infants at risk for retinopathy of prematurity (ROP) is predominantly performed with ophthalmoscopic en face viewing of the retina. While postmortem retinal microstructures have been studied at the vascular-avascular junction, a critical location for pathogenesis of ROP, to date this has not been possible in vivo. Here we present bedside, non-sedated in vivo cross-sectional imaging and analysis of retinal microstructures at the vascular-avascular junction in infants with ROP using handheld spectral-domain optical coherence tomography (SDOCT). DESIGN: Prospective observational study. PARTICIPANTS: Eleven preterm infants consented for research imaging during ROP screening examinations. METHODS: We imaged the vascular-avascular junction in the temporal retina using a SDOCT system (Envisu, Bioptigen Inc., NC) in 18 eyes from 11 preterm infants with zone I or II, stage 0 through 4 ROP. B-scan and en face images were analyzed and compared to historical light micrographs. MAIN OUTCOME MEASURES: SDOCT morphology at the vascular-avascular junction. RESULTS: Multiple bedside SDOCT findings at the vascular-avascular junction were comparable to historic light micrographs: thickened inner retinal ridge structure in stage 2 ROP was comparable to thickened vanguard and rear guard cells in micrographs; vascular tufts on the posterior retinal surface in stage 2 ROP, broad arcs of neovascularization above the retina in stage 3 ROP, and splitting of inner retinal layers into clefts on either side of neovascularization mimicked findings of historic light micrographs. A unique findings was thickening of the avascular inner retinal band adjacent to neovascularization. On SDOCT imaging over several weeks, neovascularization and retinal clefts diminished after intravitreal bevacizumab therapy. CONCLUSIONS: Retinal morphology at the vascular-avascular junction imaged with handheld SDOCT is consistent with known histopathology, and provide the advantage of monitoring change in vivo over time. These unique findings provide new insights into preterm retinal neurovascular development in ROP.

Original languageEnglish (US)
Pages (from-to)963-971
Number of pages9
JournalOphthalmology. Retina
Volume2
Issue number9
DOIs
StatePublished - Sep 1 2018
Externally publishedYes

Fingerprint

Retinal Vessels
Retinopathy of Prematurity
Optical Coherence Tomography
Blood Vessels
Premature Infants
Retina
Light
Retinal Neovascularization
Observational Studies
Cross-Sectional Studies
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Nephrology

Cite this

Spectral-Domain OCT Findings of Retinal Vascular-Avascular Junction in Infants with Retinopathy of Prematurity. / Chen, Xi; Mangalesh, Shwetha; Dandridge, Alexandria; Tran-Viet, Du; Wallace, David K.; Freedman, Sharon F.; Toth, Cynthia A.

In: Ophthalmology. Retina, Vol. 2, No. 9, 01.09.2018, p. 963-971.

Research output: Contribution to journalArticle

Chen, Xi ; Mangalesh, Shwetha ; Dandridge, Alexandria ; Tran-Viet, Du ; Wallace, David K. ; Freedman, Sharon F. ; Toth, Cynthia A. / Spectral-Domain OCT Findings of Retinal Vascular-Avascular Junction in Infants with Retinopathy of Prematurity. In: Ophthalmology. Retina. 2018 ; Vol. 2, No. 9. pp. 963-971.
@article{7721b8189e5744ec9ec0a1379ebe5d2c,
title = "Spectral-Domain OCT Findings of Retinal Vascular-Avascular Junction in Infants with Retinopathy of Prematurity",
abstract = "PURPOSE: Bedside examination of premature infants at risk for retinopathy of prematurity (ROP) is predominantly performed with ophthalmoscopic en face viewing of the retina. While postmortem retinal microstructures have been studied at the vascular-avascular junction, a critical location for pathogenesis of ROP, to date this has not been possible in vivo. Here we present bedside, non-sedated in vivo cross-sectional imaging and analysis of retinal microstructures at the vascular-avascular junction in infants with ROP using handheld spectral-domain optical coherence tomography (SDOCT). DESIGN: Prospective observational study. PARTICIPANTS: Eleven preterm infants consented for research imaging during ROP screening examinations. METHODS: We imaged the vascular-avascular junction in the temporal retina using a SDOCT system (Envisu, Bioptigen Inc., NC) in 18 eyes from 11 preterm infants with zone I or II, stage 0 through 4 ROP. B-scan and en face images were analyzed and compared to historical light micrographs. MAIN OUTCOME MEASURES: SDOCT morphology at the vascular-avascular junction. RESULTS: Multiple bedside SDOCT findings at the vascular-avascular junction were comparable to historic light micrographs: thickened inner retinal ridge structure in stage 2 ROP was comparable to thickened vanguard and rear guard cells in micrographs; vascular tufts on the posterior retinal surface in stage 2 ROP, broad arcs of neovascularization above the retina in stage 3 ROP, and splitting of inner retinal layers into clefts on either side of neovascularization mimicked findings of historic light micrographs. A unique findings was thickening of the avascular inner retinal band adjacent to neovascularization. On SDOCT imaging over several weeks, neovascularization and retinal clefts diminished after intravitreal bevacizumab therapy. CONCLUSIONS: Retinal morphology at the vascular-avascular junction imaged with handheld SDOCT is consistent with known histopathology, and provide the advantage of monitoring change in vivo over time. These unique findings provide new insights into preterm retinal neurovascular development in ROP.",
author = "Xi Chen and Shwetha Mangalesh and Alexandria Dandridge and Du Tran-Viet and Wallace, {David K.} and Freedman, {Sharon F.} and Toth, {Cynthia A.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1016/j.oret.2018.02.001",
language = "English (US)",
volume = "2",
pages = "963--971",
journal = "Ophthalmology Retina",
issn = "2468-0249",
publisher = "Elsevier Inc.",
number = "9",

}

TY - JOUR

T1 - Spectral-Domain OCT Findings of Retinal Vascular-Avascular Junction in Infants with Retinopathy of Prematurity

AU - Chen, Xi

AU - Mangalesh, Shwetha

AU - Dandridge, Alexandria

AU - Tran-Viet, Du

AU - Wallace, David K.

AU - Freedman, Sharon F.

AU - Toth, Cynthia A.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - PURPOSE: Bedside examination of premature infants at risk for retinopathy of prematurity (ROP) is predominantly performed with ophthalmoscopic en face viewing of the retina. While postmortem retinal microstructures have been studied at the vascular-avascular junction, a critical location for pathogenesis of ROP, to date this has not been possible in vivo. Here we present bedside, non-sedated in vivo cross-sectional imaging and analysis of retinal microstructures at the vascular-avascular junction in infants with ROP using handheld spectral-domain optical coherence tomography (SDOCT). DESIGN: Prospective observational study. PARTICIPANTS: Eleven preterm infants consented for research imaging during ROP screening examinations. METHODS: We imaged the vascular-avascular junction in the temporal retina using a SDOCT system (Envisu, Bioptigen Inc., NC) in 18 eyes from 11 preterm infants with zone I or II, stage 0 through 4 ROP. B-scan and en face images were analyzed and compared to historical light micrographs. MAIN OUTCOME MEASURES: SDOCT morphology at the vascular-avascular junction. RESULTS: Multiple bedside SDOCT findings at the vascular-avascular junction were comparable to historic light micrographs: thickened inner retinal ridge structure in stage 2 ROP was comparable to thickened vanguard and rear guard cells in micrographs; vascular tufts on the posterior retinal surface in stage 2 ROP, broad arcs of neovascularization above the retina in stage 3 ROP, and splitting of inner retinal layers into clefts on either side of neovascularization mimicked findings of historic light micrographs. A unique findings was thickening of the avascular inner retinal band adjacent to neovascularization. On SDOCT imaging over several weeks, neovascularization and retinal clefts diminished after intravitreal bevacizumab therapy. CONCLUSIONS: Retinal morphology at the vascular-avascular junction imaged with handheld SDOCT is consistent with known histopathology, and provide the advantage of monitoring change in vivo over time. These unique findings provide new insights into preterm retinal neurovascular development in ROP.

AB - PURPOSE: Bedside examination of premature infants at risk for retinopathy of prematurity (ROP) is predominantly performed with ophthalmoscopic en face viewing of the retina. While postmortem retinal microstructures have been studied at the vascular-avascular junction, a critical location for pathogenesis of ROP, to date this has not been possible in vivo. Here we present bedside, non-sedated in vivo cross-sectional imaging and analysis of retinal microstructures at the vascular-avascular junction in infants with ROP using handheld spectral-domain optical coherence tomography (SDOCT). DESIGN: Prospective observational study. PARTICIPANTS: Eleven preterm infants consented for research imaging during ROP screening examinations. METHODS: We imaged the vascular-avascular junction in the temporal retina using a SDOCT system (Envisu, Bioptigen Inc., NC) in 18 eyes from 11 preterm infants with zone I or II, stage 0 through 4 ROP. B-scan and en face images were analyzed and compared to historical light micrographs. MAIN OUTCOME MEASURES: SDOCT morphology at the vascular-avascular junction. RESULTS: Multiple bedside SDOCT findings at the vascular-avascular junction were comparable to historic light micrographs: thickened inner retinal ridge structure in stage 2 ROP was comparable to thickened vanguard and rear guard cells in micrographs; vascular tufts on the posterior retinal surface in stage 2 ROP, broad arcs of neovascularization above the retina in stage 3 ROP, and splitting of inner retinal layers into clefts on either side of neovascularization mimicked findings of historic light micrographs. A unique findings was thickening of the avascular inner retinal band adjacent to neovascularization. On SDOCT imaging over several weeks, neovascularization and retinal clefts diminished after intravitreal bevacizumab therapy. CONCLUSIONS: Retinal morphology at the vascular-avascular junction imaged with handheld SDOCT is consistent with known histopathology, and provide the advantage of monitoring change in vivo over time. These unique findings provide new insights into preterm retinal neurovascular development in ROP.

UR - http://www.scopus.com/inward/record.url?scp=85050890839&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050890839&partnerID=8YFLogxK

U2 - 10.1016/j.oret.2018.02.001

DO - 10.1016/j.oret.2018.02.001

M3 - Article

C2 - 30506013

AN - SCOPUS:85050890839

VL - 2

SP - 963

EP - 971

JO - Ophthalmology Retina

JF - Ophthalmology Retina

SN - 2468-0249

IS - 9

ER -