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早产儿视网膜病变病史患者光学相干断层扫描成像中的外层视网膜结构改变及分割误差

Outer Retinal Structural Alternation and Segmentation Errors in Optical Coherence Tomography Imaging in Patients With a History of Retinopathy of Prematurity.

作者信息

Chen Yi-Hsing, Lien Reyin, Chiang Michael F, Huang Chung-Ying, Chang Chee-Jen, Wang Nan-Kai, Chen Yen-Po, Chao An-Ning, Chen Kuan-Jen, Chen Tun-Lu, Hwang Yih-Shiou, Lai Chi-Chun, Wu Wei-Chi

机构信息

Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Am J Ophthalmol. 2016 Jun;166:169-180. doi: 10.1016/j.ajo.2016.03.030. Epub 2016 Mar 30.

Abstract

PURPOSE

To evaluate retinal anatomy and segmentation errors from spectral-domain optical coherence tomography (SD-OCT) imaging in school-aged children.

DESIGN

A prospective cohort study in a referral medical center.

METHODS

One hundred thirty-three eyes of 133 patients were enrolled. Patients were grouped as those who were treated for retinopathy of prematurity (ROP) (ROP-Tx group); those with spontaneously regressed ROP (ROP-non-Tx group); other premature patients (premature group); and full-term age-matched children (full-term group). Anatomy and segmentation errors of retina were evaluated by SD-OCT.

RESULTS

The mean age at assessment was 9.5 years (range, 4-16 years). The external limiting membrane (ELM) and the cone outer segment tips (COST) line were least frequently identified in patients of the ROP-Tx group (65.2% and 47.8%, P = .002 and P < .001, respectively). The visual acuity of the patients did not correlate significantly with the absence of COST line (P = .140) but correlated with the absence of ELM (P < .001). The presence of artifacts, including misidentification of the inner retina, misidentification of the outer retina, out-of-register artifacts, off-center scans, and degraded scan images, was observed to range from 0.6% to 50.0% in 4 groups of patients. All types of errors occurred more frequently in the ROP-Tx group than in the full-term group (all P < .05).

CONCLUSIONS

Outer retinal abnormalities were commonly observed in the ROP-Tx group. The higher segmentation errors in the ROP-Tx group might be related to fine structural abnormalities in the outer retina. Future studies are needed to investigate the mechanisms for these structural changes.

摘要

目的

评估学龄儿童光谱域光学相干断层扫描(SD - OCT)成像中的视网膜解剖结构及分割误差。

设计

在一家转诊医疗中心进行的前瞻性队列研究。

方法

纳入133例患者的133只眼。患者分为接受早产儿视网膜病变(ROP)治疗的患者(ROP - Tx组);ROP自然消退的患者(ROP - 非Tx组);其他早产儿患者(早产组);以及足月年龄匹配儿童(足月组)。通过SD - OCT评估视网膜的解剖结构及分割误差。

结果

评估时的平均年龄为9.5岁(范围4 - 16岁)。ROP - Tx组患者中,外限制膜(ELM)和视锥细胞外段顶端(COST)线的识别率最低(分别为65.2%和47.8%,P = 0.002和P < 0.001)。患者的视力与COST线缺失无显著相关性(P = 0.140),但与ELM缺失相关(P < 0.001)。在4组患者中,观察到包括视网膜内层误识别、视网膜外层误识别、配准不良伪像、偏心扫描和扫描图像质量下降等伪像的出现率为0.6%至50.0%。所有类型的误差在ROP - Tx组中比在足月组中更频繁出现(所有P < 0.05)。

结论

ROP - Tx组中常见外层视网膜异常。ROP - Tx组中较高的分割误差可能与外层视网膜的精细结构异常有关。未来需要研究这些结构变化的机制。

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