Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina.
Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
Ophthalmology. 2014 Jun;121(6):1289-96. doi: 10.1016/j.ophtha.2013.12.004. Epub 2014 Jan 21.
To study vascular features detected with spectral domain optical coherence tomography (SD-OCT) in subjects undergoing retinopathy of prematurity (ROP) screening.
Cross-sectional study.
Fifty-seven premature neonates, 10 with plus disease in at least 1 eye and 47 without plus disease.
Bedside noncontact SD-OCT imaging was performed after obtaining parental consent on 97 consecutive infants between January 2009 and September 2012. Fifty-seven subjects (31-49 weeks' post-menstrual age) who had an SD-OCT scan in at least 1 eye showing the edge of the optic nerve and at least 1 major retinal vascular arcade were included. One eye per subject was randomly selected for analysis. Two masked graders evaluated scans for (1) retinal vessel elevation, (2) scalloped retinal layers, (3) hyporeflective vessels, and (4) retinal spaces. To coalesce the weight of these features, a Vascular Abnormality Score by OCT (VASO) was created. For quantitative assessment of vessel elevation, retinal surface maps were created.
Prevalence of SD-OCT vascular abnormalities, the VASO, intergrader agreement, and presence of elevation on surface maps.
From among 67 SD-OCT characteristics that were recorded, the most common characteristics found were vessel elevation (44%), hyporeflective vessels (40%), scalloped layers (22%), and retinal spaces (11%). Features significantly associated with plus disease were vessel elevation (P = 0.01), hyporeflective vessels (P = 0.04), and scalloped retinal layers (P = 0.006). Intragrader agreement was between 74% and 90% for all features. The VASO was significantly higher in subjects with plus disease (P = 0.0013). On 3-dimensional SD-OCT volumes, eyes with plus disease had greater retinal surface elevation that more often matched en face retinal vascular patterns.
We present a novel 3-dimensional analysis of vascular and perivascular abnormalities identified in SD-OCT images of eyes with ROP. The SD-OCT characteristics that are more common in eyes with plus disease provide the first in vivo demonstration of the effects of vascular dilation and tortuosity on perivascular tissue. The VASO and surface maps also delineate the severity of vascular pathology in plus disease. Further studies evaluating these findings in eyes with pre-plus versus normal posterior pole vessels may determine the usefulness of SD-OCT in the early detection of vascular abnormalities in ROP.
研究接受早产儿视网膜病变（ROP）筛查的患者中应用谱域光相干断层扫描（SD-OCT）检测到的血管特征。
横断面研究。
2009 年 1 月至 2012 年 9 月期间，征得父母同意后，对连续的 97 例早产儿进行非接触式 SD-OCT 成像，其中 10 例至少 1 只眼存在 PLUS 病，47 例无 PLUS 病。
纳入至少 1 只眼的 SD-OCT 扫描显示视神经边缘和至少 1 个主要视网膜血管弓的 57 例受试者（31-49 周的胎龄）。对每个受试者的 1 只眼进行随机选择进行分析。2 名经过盲法训练的评估者评估扫描图像的视网膜血管抬高、视网膜层状凹陷、低反射血管和视网膜间隙。为了融合这些特征的权重，创建了 OCT 血管异常评分（VASO）。为了定量评估血管抬高，创建了视网膜表面图。
SD-OCT 血管异常的发生率、VASO、评估者间的一致性以及表面图上的抬高。
在记录的 67 项 SD-OCT 特征中，最常见的特征是血管抬高（44%）、低反射血管（40%）、层状凹陷（22%）和视网膜间隙（11%）。与 PLUS 病相关的特征是血管抬高（P=0.01）、低反射血管（P=0.04）和视网膜层状凹陷（P=0.006）。所有特征的评估者间一致性在 74%至 90%之间。PLUS 病患者的 VASO 明显升高（P=0.0013）。在 3 维 SD-OCT 容积上，PLUS 病眼的视网膜表面抬高更明显，并且更常与视网膜血管的平面视图相匹配。
我们提出了一种在 ROP 患者的 SD-OCT 图像中识别血管和血管周围异常的新的 3 维分析方法。PLUS 病眼中更常见的 SD-OCT 特征首次提供了血管扩张和迂曲对血管周围组织影响的体内证据。VASO 和表面图还可以描绘 PLUS 病中血管病理的严重程度。进一步研究评估前 PLUS 与正常后极血管之间的这些发现，可能有助于确定 SD-OCT 在 ROP 早期检测血管异常中的作用。
