Cai Xiaojing, Zhou Xiaohong, Wu Tiancheng, Li Yian, Yang Weiming, Yang Chenhao
Department of Ophthalmology, Children's Hospital of Fudan University, National Children's Medical Center, Wanyuan Road No.399, Shanghai, 201102, China.
BMC Ophthalmol. 2025 Jan 17;25(1):27. doi: 10.1186/s12886-025-03867-6.
To evaluate the macular development in preterm infants with spontaneously regressed retinopathy of prematurity (ROP) utilizing handheld spectral domain optical coherence tomography (SD-OCT) during the early postnatal period.
A cross-sectional observational study.
Using handheld SD-OCT, OCT images were acquired in non-sedated infants ages about 37 weeks(w) post-menstrual-age (PMA = gestational age in weeks + chronological age). Central foveal thickness (CFT), mean parafoveal thickness (PT, mean of the temporal and nasal-lateral retinal thickness 1000 μm from the foveal center), the thickness of inner retina layers (IRL) and outer retina layers (ORL) of the foveal center and parafoveal, the depth of the macular fovea (FD), and the angle of the macular fovea (FA) were measured and analyzed.
In contrast to the infants without ROP (group 1), OCT images of the infants with spontaneously regressed ROP (group 2) were more immature. The FD of Group 2 was shallower than Group 1 (P < 0.05); CFT and the foveal center IRL (FIRL) of Group 2 were thicker than Group 1 (P < 0.05); conversely, PT and the mean parafoveal IRL (PIRL) of Group 2 were thinner than Group 1 (P < 0.05); FA of Group 2 was bigger than Group 1 (P < 0.05); however, there was no significant difference in the foveal center ORL (FORL) and the mean parafoveal ORL (PORL) between Groups 1 and 2 (P > 0.05). Furthermore, in preterm infants, ROP was moderately correlated with FD, CFT, PT, FIRL, and PIRL (P < 0.05).
The spontaneously regressed ROP resulted in immature macular development in the early postnatal period. The inner retinal layers mainly contribute to this but not the outer retinal layers, indicating that the macular fovea's inner and outer retina layers developed asynchronously. ROP is an influential factor in macular development and maturation. This may be associated with the higher probability of visual impairment in children with a history of spontaneous regression of ROP at a prior time.
利用手持式光谱域光学相干断层扫描(SD-OCT)评估早产视网膜病变(ROP)自然消退的早产儿出生后早期黄斑的发育情况。
横断面观察性研究。
使用手持式SD-OCT,对月经龄约37周(PMA = 孕周 + 实际年龄)的非镇静婴儿采集OCT图像。测量并分析中心凹厚度(CFT)、平均中心凹旁厚度(PT,中心凹中心颞侧和鼻侧视网膜厚度1000μm处的平均值)、中心凹中心和中心凹旁的视网膜内层(IRL)和外层(ORL)厚度、黄斑中心凹深度(FD)以及黄斑中心凹角度(FA)。
与无ROP的婴儿(第1组)相比,ROP自然消退的婴儿(第2组)的OCT图像更不成熟。第2组的FD比第1组浅(P < 0.05);第2组的CFT和中心凹中心IRL(FIRL)比第1组厚(P < 0.05);相反,第2组的PT和平均中心凹旁IRL(PIRL)比第1组薄(P < 0.05);第2组的FA比第1组大(P < 0.05);然而,第1组和第2组之间中心凹中心ORL(FORL)和平均中心凹旁ORL(PORL)无显著差异(P > 0.05)。此外,在早产儿中,ROP与FD、CFT、PT、FIRL和PIRL中度相关(P < 0.05)。
ROP自然消退导致出生后早期黄斑发育不成熟。主要是视网膜内层导致这种情况,而非外层,这表明黄斑中心凹的视网膜内层和外层发育不同步。ROP是黄斑发育和成熟的一个影响因素。这可能与既往有ROP自然消退史的儿童视力损害概率较高有关。