Spectral-domain optical coherence tomographic assessment of severity of cystoid macular edema in retinopathy of prematurity

Ramiro S. Maldonado, Rachelle O'Connell, Simon B. Ascher, Neeru Sarin, Sharon F. Freedman, David K. Wallace, Stephanie J. Chiu, Sina Farsiu, Michael Cotten, Cynthia A. Toth

Research output: Contribution to journalArticle

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Abstract

Objective: To investigate whether the severity of cystoid macular edema (CME) in neonates who were 31 to 36 weeks' postmenstrual age, as viewed by spectral-domain optical coherence tomography (SD-OCT) imaging, predicts the severity of retinopathy of prematurity (ROP) or is related to systemic health. Design: Of 62 prematurely born neonates in a prospective institutional review board-approved study, 42 met the following inclusion criteria: at least 1 SD-OCT imaging session prior to 37 weeks' postmenstrual age and prior to ROP laser treatment, if a laser treatment was performed, and an ophthalmic ROP examination at or after 41 weeks' postmenstrual age, evidence of complete retinal vascularization in zone III, or documentation through telephone report of such information after transfer of care. Measures of CME severity, including central foveal thickness, retinal layer thicknesses, and foveal-to-parafoveal thickness ratio in 1 eye per subject, were compared with ROP outcomes: laser treatment, maximum plus disease, and maximum ROP stage. Systemic health factors were also correlated. Results: Cystoid macular edema was present in 50% of neonates. Multiple elongated cystoid structures within the inner nuclear layer were most common. The presence of CME was not associated with ROP outcomes. The central foveal thickness, the thickness of the inner retinal layers, and the foveal-to-parafoveal thickness ratio were higher in eyes that required laser treatment or that developed plus disease or ROP stage 3. Cystoid macular edema was not clearly associated with systemic factors. Conclusions: Cystoid macular edema is common in premature-infants screened for ROP before 37 weeks' postmenstrual age, with the most common SD-OCT phenotype of a bulging fovea from multiple elongated cystoid spaces. Detection of CME is not associated with ROP severity; however, tomographic thickness measurements could potentially predict a higher risk of requiring laser treatment or developing plus disease or ROP stage 3. Systemic health factors are probably not related to the development of CME.

Original languageEnglish (US)
Pages (from-to)569-578
Number of pages10
JournalArchives of Ophthalmology
Volume130
Issue number5
DOIs
StatePublished - Mar 1 2012
Externally publishedYes

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Retinopathy of Prematurity
Macular Edema
Lasers
Optical Coherence Tomography
Newborn Infant
Health
Research Ethics Committees
Therapeutics
Telephone
Premature Infants
Documentation
Phenotype

ASJC Scopus subject areas

  • Ophthalmology

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Spectral-domain optical coherence tomographic assessment of severity of cystoid macular edema in retinopathy of prematurity. / Maldonado, Ramiro S.; O'Connell, Rachelle; Ascher, Simon B.; Sarin, Neeru; Freedman, Sharon F.; Wallace, David K.; Chiu, Stephanie J.; Farsiu, Sina; Cotten, Michael; Toth, Cynthia A.

In: Archives of Ophthalmology, Vol. 130, No. 5, 01.03.2012, p. 569-578.

Research output: Contribution to journalArticle

Maldonado, RS, O'Connell, R, Ascher, SB, Sarin, N, Freedman, SF, Wallace, DK, Chiu, SJ, Farsiu, S, Cotten, M & Toth, CA 2012, 'Spectral-domain optical coherence tomographic assessment of severity of cystoid macular edema in retinopathy of prematurity', Archives of Ophthalmology, vol. 130, no. 5, pp. 569-578. https://doi.org/10.1001/archopthalmol.2011.1846
Maldonado, Ramiro S. ; O'Connell, Rachelle ; Ascher, Simon B. ; Sarin, Neeru ; Freedman, Sharon F. ; Wallace, David K. ; Chiu, Stephanie J. ; Farsiu, Sina ; Cotten, Michael ; Toth, Cynthia A. / Spectral-domain optical coherence tomographic assessment of severity of cystoid macular edema in retinopathy of prematurity. In: Archives of Ophthalmology. 2012 ; Vol. 130, No. 5. pp. 569-578.
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abstract = "Objective: To investigate whether the severity of cystoid macular edema (CME) in neonates who were 31 to 36 weeks' postmenstrual age, as viewed by spectral-domain optical coherence tomography (SD-OCT) imaging, predicts the severity of retinopathy of prematurity (ROP) or is related to systemic health. Design: Of 62 prematurely born neonates in a prospective institutional review board-approved study, 42 met the following inclusion criteria: at least 1 SD-OCT imaging session prior to 37 weeks' postmenstrual age and prior to ROP laser treatment, if a laser treatment was performed, and an ophthalmic ROP examination at or after 41 weeks' postmenstrual age, evidence of complete retinal vascularization in zone III, or documentation through telephone report of such information after transfer of care. Measures of CME severity, including central foveal thickness, retinal layer thicknesses, and foveal-to-parafoveal thickness ratio in 1 eye per subject, were compared with ROP outcomes: laser treatment, maximum plus disease, and maximum ROP stage. Systemic health factors were also correlated. Results: Cystoid macular edema was present in 50{\%} of neonates. Multiple elongated cystoid structures within the inner nuclear layer were most common. The presence of CME was not associated with ROP outcomes. The central foveal thickness, the thickness of the inner retinal layers, and the foveal-to-parafoveal thickness ratio were higher in eyes that required laser treatment or that developed plus disease or ROP stage 3. Cystoid macular edema was not clearly associated with systemic factors. Conclusions: Cystoid macular edema is common in premature-infants screened for ROP before 37 weeks' postmenstrual age, with the most common SD-OCT phenotype of a bulging fovea from multiple elongated cystoid spaces. Detection of CME is not associated with ROP severity; however, tomographic thickness measurements could potentially predict a higher risk of requiring laser treatment or developing plus disease or ROP stage 3. Systemic health factors are probably not related to the development of CME.",
author = "Maldonado, {Ramiro S.} and Rachelle O'Connell and Ascher, {Simon B.} and Neeru Sarin and Freedman, {Sharon F.} and Wallace, {David K.} and Chiu, {Stephanie J.} and Sina Farsiu and Michael Cotten and Toth, {Cynthia A.}",
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AU - Maldonado, Ramiro S.

AU - O'Connell, Rachelle

AU - Ascher, Simon B.

AU - Sarin, Neeru

AU - Freedman, Sharon F.

AU - Wallace, David K.

AU - Chiu, Stephanie J.

AU - Farsiu, Sina

AU - Cotten, Michael

AU - Toth, Cynthia A.

PY - 2012/3/1

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N2 - Objective: To investigate whether the severity of cystoid macular edema (CME) in neonates who were 31 to 36 weeks' postmenstrual age, as viewed by spectral-domain optical coherence tomography (SD-OCT) imaging, predicts the severity of retinopathy of prematurity (ROP) or is related to systemic health. Design: Of 62 prematurely born neonates in a prospective institutional review board-approved study, 42 met the following inclusion criteria: at least 1 SD-OCT imaging session prior to 37 weeks' postmenstrual age and prior to ROP laser treatment, if a laser treatment was performed, and an ophthalmic ROP examination at or after 41 weeks' postmenstrual age, evidence of complete retinal vascularization in zone III, or documentation through telephone report of such information after transfer of care. Measures of CME severity, including central foveal thickness, retinal layer thicknesses, and foveal-to-parafoveal thickness ratio in 1 eye per subject, were compared with ROP outcomes: laser treatment, maximum plus disease, and maximum ROP stage. Systemic health factors were also correlated. Results: Cystoid macular edema was present in 50% of neonates. Multiple elongated cystoid structures within the inner nuclear layer were most common. The presence of CME was not associated with ROP outcomes. The central foveal thickness, the thickness of the inner retinal layers, and the foveal-to-parafoveal thickness ratio were higher in eyes that required laser treatment or that developed plus disease or ROP stage 3. Cystoid macular edema was not clearly associated with systemic factors. Conclusions: Cystoid macular edema is common in premature-infants screened for ROP before 37 weeks' postmenstrual age, with the most common SD-OCT phenotype of a bulging fovea from multiple elongated cystoid spaces. Detection of CME is not associated with ROP severity; however, tomographic thickness measurements could potentially predict a higher risk of requiring laser treatment or developing plus disease or ROP stage 3. Systemic health factors are probably not related to the development of CME.

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