Department of Ophthalmology, University of Washington, Seattle, Washington.
Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma City, Oklahoma.
J AAPOS. 2021 Jun;25(3):153.e1-153.e6. doi: 10.1016/j.jaapos.2020.12.007. Epub 2021 May 24.
To describe dome-shaped macula and associated clinical findings in premature infants.
This prospective, observational cohort study included a consecutive sample of premature infants screened for retinopathy of prematurity (ROP) with 9-month follow-up. Handheld spectral domain optical coherence tomography (SD-OCT) was performed at the time of ROP screening. Images were assessed for dome-shaped macula, cystoid macular edema, epiretinal membrane, vitreous bands, and punctate hyperreflective vitreous opacities. Dome height measurements were performed in a subset of images. Teller visual acuity and cycloplegic refraction were performed at an adjusted age of 8-10 months.
Of 37 infants (74 eyes; 49% male; mean gestational age 27.8 ± 3.2 weeks; mean birth weight 949 ± 284 g), 24/37 (65%) demonstrated dome-shaped macula in at least one eye (13 both eyes, 5 right eye only, and 6 left eye only). Of the 74 eyes, 26 (35%) could be reliably measured, with a mean dome height of 139.0 ± 72.3 μm (range, 54-369 μm). Presence of dome-shaped macula was associated with a diagnosis of ROP (P = 0.02; OR, 3.03; 95% CI, 1.18-7.82) and pre-plus or plus disease (P = 0.02; OR, 4.20; 95% CI, 1.05-16.78). Infants with dome-shaped macula had lower birth weight compared with those without (877 vs 1081 g; P = 0.04). No associations with other demographics, OCT findings, and 9-month refractive outcomes were found.
Dome-shaped macula was frequently identified by handheld SD-OCT in premature infants, especially those with lower birth weight and severe ROP. The long-term clinical significance of this finding is unknown.
描述早产儿的穹顶形黄斑及其相关临床发现。
本前瞻性观察队列研究纳入了连续筛查早产儿视网膜病变（ROP）的早产儿样本，并进行了 9 个月的随访。在 ROP 筛查时进行手持谱域光学相干断层扫描（SD-OCT）。对图像进行评估，以确定穹顶形黄斑、囊样黄斑水肿、视网膜内膜、玻璃体带和点状高反射玻璃体混浊。在一部分图像中进行穹顶高度测量。在调整后的 8-10 月龄时进行 Teller 视力和睫状肌麻痹验光。
37 名婴儿（74 只眼；49%为男性；平均胎龄 27.8±3.2 周；平均出生体重 949±284 克）中，24/37（65%）至少有一只眼存在穹顶形黄斑（13 只双眼，5 只右眼，6 只左眼）。74 只眼中，26 只（35%）可进行可靠测量，平均穹顶高度为 139.0±72.3μm（范围 54-369μm）。存在穹顶形黄斑与 ROP（P=0.02；OR，3.03；95%CI，1.18-7.82）和前加或加疾病（P=0.02；OR，4.20；95%CI，1.05-16.78）的诊断有关。存在穹顶形黄斑的婴儿出生体重低于无穹顶形黄斑的婴儿（877 克与 1081 克；P=0.04）。未发现与其他人口统计学、OCT 发现和 9 个月屈光结果相关的因素。
手持 SD-OCT 经常在早产儿中发现穹顶形黄斑，尤其是那些出生体重较低和患有严重 ROP 的早产儿。该发现的长期临床意义尚不清楚。
