Alabduljalil Talal, Westall Carol A, Reginald Arun, Farsiu Sina, Chiu Stephanie J, Arshavsky Alec, Toth Cynthia A, Lam Wai-Ching
SickKids Hospital, Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.
Vision and Image Processing (VIP) Laboratory, Departments of Ophthalmology and Biomedical Engineering, Duke University, Durham, NC, USA.
Int Ophthalmol. 2019 Jul;39(7):1533-1542. doi: 10.1007/s10792-018-0966-3. Epub 2018 Jun 23.
To demonstrate the anatomical development of the human macula using handheld spectral domain optical coherence tomography (SD-OCT) during the first 5 years of life.
This study is a cross-sectional, observational case series. Thirty-five normal eyes of 35 full-term/late preterm infants and children under 5 years of age were included. Handheld SD-OCT was used to image the macula of each eye. The data were analyzed using the Duke OCT Retinal Analysis Program v17 software. Retinal thickness maps were generated for the total retinal thickness (TRT), the inner retinal layers thickness (IRL), and the photoreceptor layer thickness (PRL). Based on the early treatment diabetic retinopathy study macular map, average thickness measurements were taken at 4 circles centered on the fovea (diameter): the foveal center (0.5 mm), sector 1 (S1) (1 mm), sector 2 (S2) (3 mm), sector 3 (S3) (6 mm).
The median age at participation was 24 months (range 5-52 months). The TRT increased throughout the first 5 years of life, and this increase was statistically significant at the foveal center and S1 (p = 0.01, p = 0.016, respectively). The IRL did not show any significant change in thickness from birth and throughout the first 5 years of life. The PRL thickness showed thickening in the first 24 months of age at the foveal center and S1 which was statistically significant at S1 (p = 0.066, p = 0.016, respectively). Interestingly, this PRL thickness increase plateaus beyond 24 months of age. The photoreceptors inner segment/outer segment (IS/OS) band was identified as a distinct layer in all our subjects.
Our findings conform with the literature that the anatomical development of the macular IRL completes before 5 months of age and hence before the PRL. We also identify 24 months of age as an important developmental milestone for photoreceptors development in the human macula.
利用手持式光谱域光学相干断层扫描（SD-OCT）展示人类黄斑在生命最初5年的解剖发育情况。
本研究为横断面观察性病例系列。纳入35名足月/晚期早产儿及5岁以下儿童的35只正常眼睛。使用手持式SD-OCT对每只眼睛的黄斑进行成像。数据采用杜克大学OCT视网膜分析程序v17软件进行分析。生成了总视网膜厚度（TRT）、视网膜内层厚度（IRL）和光感受器层厚度（PRL）的视网膜厚度图。基于早期糖尿病视网膜病变研究黄斑图，在以黄斑中心为中心的4个圆圈（直径）处进行平均厚度测量：黄斑中心（0.5毫米）、扇形1（S1）（1毫米）、扇形2（S2）（3毫米）、扇形3（S3）（6毫米）。
参与研究的中位年龄为24个月（范围5 - 52个月）。TRT在生命的前5年中持续增加，在黄斑中心和S1处这种增加具有统计学意义（分别为p = 0.01，p = 0.016）。IRL从出生到生命的前5年厚度未显示出任何显著变化。PRL厚度在24个月龄前在黄斑中心和S1处增厚，在S1处具有统计学意义（分别为p = 0.066，p = 0.016）。有趣的是，这种PRL厚度增加在24个月龄后趋于平稳。在我们所有受试者中，光感受器内节/外节（IS/OS）带被识别为一个独特的层。
我们的研究结果与文献一致，即黄斑IRL的解剖发育在5个月龄之前完成，因此早于PRL。我们还确定24个月龄是人类黄斑光感受器发育的一个重要发育里程碑。
