Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
Ophthalmology. 2013 Aug;120(8):1665-71. doi: 10.1016/j.ophtha.2013.01.028. Epub 2013 May 11.
To evaluate subclinical macular findings in premature patients at risk of retinopathy of prematurity (ROP) with the use of handheld spectral-domain optical coherence tomography (SD-OCT).
Prospective, observational case series.
Forty-nine prematurely born neonates.
Forty-nine infants were imaged using a handheld SD-OCT. Images were acquired in nonsedated infants in the neonatal intensive care unit (NICU). Some patients were followed and reimaged over the course of several weeks. A total of 300 total images were acquired and evaluated for cystoid macular edema (CME) and persistence of inner retinal layers.
In vivo determination of foveal retinal lamination, image analysis, and clinical observation.
A total of 241 (80%) of the images from 46 patients were usable (defined as having scans passing through the fovea with clearly identifiable retinal layers). Persistence of 1 or more inner retinal layers was seen in 43 of the patients with usable images (93%). Of the patients with at least 1 persistent layer, 17, 4, 8, 12, and 1, had a maximum ROP stage of 0, 1, 2, 3, and 4A, respectively. Cystoid macular edema was seen in 25 of the 46 patients (54%) during 1 or more imaging sessions. Cystoid macular edema was present in 9, 1, 5, 9, and 1 patient with maximum ROP stage of 0, 1, 2, 3, and 4A, respectively.
Our data suggest there is persistence of inner retinal layers in premature infants regardless of maximal ROP stage. Subclinical CME is seen in premature infants; however, CME does not appear to be correlated with ROP stage. This suggests that there may be other causes for the CME seen in this patient population. Hand-held SD-OCT imaging is a viable technique for evaluating subclinical macular findings in premature infants, although larger datasets are needed from multiple centers to further evaluate the generalizability of these findings.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
使用手持谱域光相干断层扫描（SD-OCT）评估有发生早产儿视网膜病变（ROP）风险的早产儿的亚临床黄斑病变。
前瞻性观察性病例系列。
49 名早产儿。
对 49 名婴儿使用手持 SD-OCT 进行成像。在新生儿重症监护病房（NICU）中对非镇静婴儿进行图像采集。一些患者在数周内进行了随访和重新成像。共采集和评估了 300 张总图像，以确定是否存在囊样黄斑水肿（CME）和内层视网膜的持续存在。
在体确定黄斑视网膜分层、图像分析和临床观察。
在 46 名患者的 241 张（80%）图像中，有 241 张（80%）可用于（定义为穿过黄斑区的扫描，有明确可识别的视网膜层）。在有可用图像的 43 名患者中，可见 1 层或多层内层视网膜持续存在（93%）。在至少有 1 层持续存在的患者中，17、4、8、12 和 1 名患者的最大 ROP 分期分别为 0、1、2、3 和 4A。在 46 名患者中的 25 名（54%）在 1 次或多次成像过程中出现了 CME。在最大 ROP 分期为 0、1、2、3 和 4A 的 9、1、5、9 和 1 名患者中，分别有 9、1、5、9 和 1 名患者出现 CME。
我们的数据表明，无论最大 ROP 分期如何，早产儿的内层视网膜都会持续存在。在早产儿中可观察到亚临床 CME；然而，CME 似乎与 ROP 分期无关。这表明在该患者人群中，CME 可能还有其他原因。手持 SD-OCT 成像技术是评估早产儿亚临床黄斑病变的一种可行技术，但需要来自多个中心的更大数据集来进一步评估这些发现的普遍性。
作者在本文讨论的材料中没有任何专有或商业利益。
