通过手持式扫频源光学相干断层扫描对黄斑未成熟进行的半自动测量与早产儿视网膜病变的严重程度相关。

Semiautomated measures of foveal immaturity from handheld swept-source optical coherence tomography are associated with retinopathy of prematurity severity.

作者信息

Tam Emily K, Lee Karen E, Lawson Sumner E, Monger Tatiana R, Legocki Alex T, Kelly John P, Liu Teng, Zheng Yujiao, Ding Leona, Tarczy-Hornoch Kristina, Wang Ruikang, Cabrera Michelle T

机构信息

Ophthalmology, Seattle Children's Hospital, Seattle, Washington, USA.

Ophthalmology, University of Washington, Seattle, Washington, USA.

出版信息

Br J Ophthalmol. 2025 Apr 22;109(5):549-553. doi: 10.1136/bjo-2023-324220.

DOI:10.1136/bjo-2023-324220

PMID:39603717

Abstract

BACKGROUND/AIMS: Handheld swept-source optical coherence tomography (SS-OCT) was previously used to measure foveal maturity through semiautomated methods in awake premature infants. This study assesses the relationship between foveal maturity and retinopathy of prematurity (ROP) severity.

METHODS

This is a prospective, observational study using handheld SS-OCT imaging of premature infants undergoing ROP screening. A semiautomated segmentation algorithm measured foveal angle, total retinal cross-sectional area, and retinal and choroid thicknesses at the fovea and parafovea, excluding significant macular oedema. Measures were correlated with ROP severity using a mixed model approach.

RESULTS

99 eye imaging sessions from 26 preterm infants were included. Average birth weight was 1057.6±324.8 g. Gestational age and postmenstrual age at imaging were 29.1±3.0 and 36.1±3.8 weeks, respectively. Stage 3 ROP occurred in 16/99 (16.2%) exams. Shallow foveal angle and higher inner retinal fovea/parafoveal (F/P) ratio correlated with more posterior ROP zone (zone 2: 119.2°±20.9° vs zone 3: 96.5°±16.7° and zone 2: 0.6±0.2 vs zone 3: 0.4±0.1, respectively, both p<0.001). Inner retinal F/P ratio was greater in eyes with higher ROP stage (stage 3: 0.6±0.2 vs stage 0 or mature: 0.4±0.2, p=0.03) but this relationship was not seen for outer retina (p=0.29). Larger retinal cross-sectional area coincided with worse ROP stage (stage 3: 1.9±0.06 mm vs stage 0 or mature: 1.6±0.04 mm, p<0.001) and zone (zone 2: 1.6±0.04 mm vs zone 3: 1.7±0.04 mm, p=0.01).

CONCLUSIONS

SS-OCT semiautomated measurements of inner retinal F/P ratio, foveal angle and retinal cross-sectional area may serve as ROP severity biomarkers.

摘要

背景/目的：手持式扫频光学相干断层扫描（SS-OCT）此前曾用于通过半自动方法测量清醒状态下早产儿的黄斑成熟度。本研究评估黄斑成熟度与早产儿视网膜病变（ROP）严重程度之间的关系。

方法

这是一项前瞻性观察性研究，对接受ROP筛查的早产儿进行手持式SS-OCT成像。一种半自动分割算法测量了黄斑角度、视网膜总横截面积以及黄斑和黄斑旁区域的视网膜和脉络膜厚度，排除了明显的黄斑水肿。采用混合模型方法将测量结果与ROP严重程度进行关联。

结果

纳入了26名早产儿的99次眼部成像检查。平均出生体重为1057.6±324.8克。成像时的胎龄和孕龄分别为29.1±3.0周和36.1±3.8周。16/99（16.2%）次检查出现3期ROP。较浅的黄斑角度和较高的视网膜内黄斑/黄斑旁（F/P）比值与更靠后的ROP区域相关（2区：119.2°±20.9°，3区：96.5°±16.7°；2区：0.6±0.2，3区：0.4±0.1，p均<0.001）。ROP分期较高的眼睛视网膜内F/P比值更大（3期：0.6±0.2，0期或成熟：0.4±0.2，p = 0.03），但视网膜外层未观察到这种关系（p = 0.29）。更大的视网膜横截面积与更严重的ROP分期（3期：1.9±0.06毫米，0期或成熟：1.6±0.04毫米，p<0.001）和区域（2区：1.6±0.04毫米，3区：1.7±0.04毫米，p = 0.01）相符。