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Addo EK, Gorka JE, Allman SJ, Harrison DY, Sharifzadeh M, Hoffman RO, Hartnett ME, Varner MW, Bernstein PS. Ocular Effects of Prenatal Carotenoid Supplementation in the Mother and Her Child: The Lutein and Zeaxanthin in Pregnancy (L-ZIP) Randomized Trial - Report Number 2. OPHTHALMOLOGY SCIENCE 2024; 4:100537. [PMID: 39071916 PMCID: PMC11283155 DOI: 10.1016/j.xops.2024.100537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/21/2024] [Accepted: 04/16/2024] [Indexed: 07/30/2024]
Abstract
Purpose Lutein (L) and zeaxanthin (Z) are xanthophyll carotenoids that have been promoted to enhance maternal health and infant visual and neurodevelopment. In this study, we determined the effects of prenatal L and Z supplementation on systemic and ocular carotenoid status in the mother and her newborn infant (NCT03750968). This report focuses on the ocular effects of prenatal carotenoid supplementation. Design A prospective randomized clinical trial with 47 subjects randomly assigned by 1:1 allocation to receive standard-of-care prenatal vitamins along with 10 mg L and 2 mg Z softgel (Carotenoid Group) or standard-of-care prenatal vitamins with a placebo softgel (Control Group) starting in the first trimester. Subjects We enrolled low-risk pregnancy subjects aged ≥18 years from the obstetrics and gynecology clinic of the University of Utah Hospital. Methods Maternal macular, skin, and serum carotenoid concentrations were measured using autofluorescence imaging, resonance Raman spectroscopy, and high-performance liquid chromatography, respectively. Infants' ocular carotenoids and retinal architecture were measured by blue light reflectance imaging and spectral-domain OCT, respectively. Main Outcome Measures Changes in maternal and infant macular pigment, skin, and serum carotenoid status over the study period. Differences in infants' retinal maturity indicators between the 2 study groups. Results Following supplementation, there was a statistically significant increase in maternal macular pigment optical volume (P < 0.001) in the Carotenoid Group relative to the Control Group at all study time points, and there was no detectable maternal ocular carotenoid depletion. Infant skin and serum carotenoids increased significantly in the Carotenoid Group compared with the Control Group. As exploratory endpoints, infants in the Carotenoid Group had a 20% increase in macular pigment optical density (P = 0.242) and more mature foveal parameters compared with those in the Control Group. Conclusion Prenatal carotenoid supplementation significantly increased maternal and infant systemic carotenoids and caused a pattern of increased infant ocular carotenoid status, which may benefit both mothers and their infants' ocular development and function. This study provides important data to design and power a future multicenter study of prenatal carotenoid supplementation in higher-risk pregnancies. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Emmanuel K. Addo
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Joanna E. Gorka
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
| | - Susan J. Allman
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
| | - Deborah Y. Harrison
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
| | - Mohsen Sharifzadeh
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
| | - Robert O. Hoffman
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
| | - M. Elizabeth Hartnett
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
| | - Michael W. Varner
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
| | - Paul S. Bernstein
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
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Bacci GM, Marziali E, Bargiacchi S, Paques M, Virgili G, Fortunato P, Durand M, Rocca C, Pagliazzi A, Palazzo V, Tiberi L, Vergani D, Landini S, Peron A, Artuso R, Pacini B, Stabile M, Sodi A, Caputo R. Multimodal phenotyping of foveal hypoplasia in albinism and albino-like conditions: a pediatric case series with adaptive optics insights. Sci Rep 2024; 14:15454. [PMID: 38965328 PMCID: PMC11224352 DOI: 10.1038/s41598-024-66326-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024] Open
Abstract
Aim of the present study is to evaluate the relationship between genetic and phenotypic data in a series of patients affected by grade I and II of foveal hypoplasia with stable fixation and good visual acuity using multimodal imaging techniques. All patients underwent complete clinical and instrumental assessment including structural Optical Coherence Tomography (OCT), OCT Angiography and Adaptive Optics (AO) imaging. Central macular thickness (CMT), inner nuclear layer (INL), vessel density in superficial capillary plexus were the main variables evaluated with OCT technology. Cone density, cone spacing, cone regularity, cone dispersion and angular density were the parameters evaluated with AO. Genetic evaluation and trio exome sequencing were performed in all affected individuals. Eight patients (3 males and 5 females) with a mean age of 12.62 years (range 8-18) were enrolled. The mean best corrected visual acuity (BCVA) was 0.18 ± 0.13 logMAR, mean CMT was 291.9 ± 16.6 µm and INL was 26.2 ± 4.6 µm. The absence of a foveal avascular zone (FAZ) was documented by examination of OCT-A in seven patients in the superficial capillary plexus. However, there was a partial FAZ in the deep plexus in patients P5 and P8. Of note, all the patients presented with major retinal vessels clearly crossing the foveal center. All individuals exhibited a grade I or II of foveal hypoplasia. In 5 patients molecular analyses showed an extremely mild form of albinism caused by compound heterozygosity of a TYR pathogenic variant and the hypomorphic p.[Ser192Tyr;Arg402Gln] haplotype. One patient had Waardenburg syndrome type 2A caused by a de novo variant in MITF. Two patients had inconclusive molecular analyses. All the patients displayed abnormalities on OCT-A. Photoreceptor count did not differ from normal subjects according to the current literature, but qualitative analysis of AO imaging showed distinctive features likely related to an abnormal pigment distribution in this subset of individuals. In patients with foveal hypoplasia, genetic and multimodal imaging data, including AO findings, can help understand the physiopathology of the foveal hypoplasia phenotype. This study confirms that cone density and visual function can both be preserved despite the absence of a pit.
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Affiliation(s)
- Giacomo M Bacci
- Pediatric Ophthalmology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139, Firenze, Italy.
| | - Elisa Marziali
- Pediatric Ophthalmology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139, Firenze, Italy
| | - Sara Bargiacchi
- Medical Genetics Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Michel Paques
- Clinical Investigation Center Vision 1423, INSERM-DGOS, Sorbonne Université, Quinze-Vingts Hospital, Paris, France
- Institut de la Vision, Paris, France
| | - Gianni Virgili
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- IRCCS - Fondazione Bietti, Rome, Italy
| | - Pina Fortunato
- Pediatric Ophthalmology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139, Firenze, Italy
| | | | - Camilla Rocca
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Angelica Pagliazzi
- Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium
| | - Viviana Palazzo
- Medical Genetics Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Lucia Tiberi
- Medical Genetics Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Debora Vergani
- Medical Genetics Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Samuela Landini
- Medical Genetics Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Angela Peron
- Medical Genetics Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Rosangela Artuso
- Medical Genetics Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Bianca Pacini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Monica Stabile
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Andrea Sodi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Roberto Caputo
- Pediatric Ophthalmology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139, Firenze, Italy
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Choi J, Joisher HNV, Gill HK, Lin L, Cepko C. Characterization of the development of the high-acuity area of the chick retina. Dev Biol 2024; 511:39-52. [PMID: 38548147 DOI: 10.1016/j.ydbio.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
The fovea is a small region within the central retina that is responsible for our high acuity daylight vision. Chickens also have a high acuity area (HAA), and are one of the few species that enables studies of the mechanisms of HAA development, due to accessible embryonic tissue and methods to readily perturb gene expression. To enable such studies, we characterized the development of the chick HAA using single molecule fluorescent in situ hybridization (smFISH), along with more classical methods. We found that Fgf8 provides a molecular marker for the HAA throughout development and into adult stages, allowing studies of the cellular composition of this area over time. The radial dimension of the ganglion cell layer (GCL) was seen to be the greatest at the HAA throughout development, beginning during the period of neurogenesis, suggesting that genesis, rather than cell death, creates a higher level of retinal ganglion cells (RGCs) in this area. In contrast, the HAA acquired its characteristic high density of cone photoreceptors post-hatching, which is well after the period of neurogenesis. We also confirmed that rod photoreceptors are not present in the HAA. Analyses of cell death in the developing photoreceptor layer, where rods would reside, did not show apoptotic cells, suggesting that lack of genesis, rather than death, created the "rod-free zone" (RFZ). Quantification of each cone photoreceptor subtype showed an ordered mosaic of most cone subtypes. The changes in cellular densities and cell subtypes between the developing and mature HAA provide some answers to the overarching strategy used by the retina to create this area and provide a framework for future studies of the mechanisms underlying its formation.
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Affiliation(s)
- Jiho Choi
- Department of Genetics, Blavatnik Institute, USA; Department of Ophthalmology, Harvard Medical School, USA; Howard Hughes Medical Institute, USA
| | - Heer N V Joisher
- Department of Genetics, Blavatnik Institute, USA; Department of Ophthalmology, Harvard Medical School, USA; Howard Hughes Medical Institute, USA
| | | | - Lucas Lin
- Department of Genetics, Blavatnik Institute, USA; Department of Ophthalmology, Harvard Medical School, USA; Howard Hughes Medical Institute, USA
| | - Constance Cepko
- Department of Genetics, Blavatnik Institute, USA; Department of Ophthalmology, Harvard Medical School, USA; Howard Hughes Medical Institute, USA.
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Huang WC, Ohnsman CM, Atiskova Y, Falabella P, Spitzer MS, Schulz A, Dulz S. OCT Biomarkers in Ocular CLN2 Disease in Patients Treated With Intraventricular Enzyme Replacement Therapy. Invest Ophthalmol Vis Sci 2024; 65:45. [PMID: 39078732 DOI: 10.1167/iovs.65.8.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
Purpose Bilateral progressive, symmetrical loss of central retinal thickness (CRT) has been described in neuronal ceroid lipofuscinosis type 2 (CLN2) disease. This study details the pattern of morphological changes underlying CRT loss and disease progression in patients receiving intracerebroventricular (ICV) enzyme replacement therapy (ERT) with cerliponase alfa. Methods Spectral-domain optical coherence tomography macular cube scans were collected from 16 patients with classic CLN2 disease receiving ICV ERT. Detailed retinal structure analyses were performed on manually segmented horizontal B-scans through the fovea to determine the thickness of six retinal parameters and the extent of ellipsoid zone (EZ) loss. Results Anatomical changes primarily occurred in photoreceptor (PR)-related retinal parameters and correlated with ocular disease severity. Retinal degeneration began with initial focal parafoveal EZ discontinuities signaling the onset of rapid PR degeneration in a predictable pattern: parafoveal PR involvement with foveal sparing followed by profound parafoveal and foveal PR loss with additional thinning beyond the central retina. PR degeneration began with outer segment loss and progressed to outer nuclear layer (ONL) involvement. Longitudinal analyses confirmed these observations. The rate of PR loss was fastest at the fovea at ∼58 mm per year and became slower at locations farther away from the fovea. Conclusions Retinal degeneration in CLN2 disease is primarily associated with PR loss in a predictable pattern, with EZ disruption signaling early PR stress. CRT, ONL thickness, and PR layer thickness are useful anatomical biomarkers for understanding disease progression and treatment efficacy in CLN2. Studies using en face images will further clarify CLN2-related retinal degeneration.
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Affiliation(s)
| | | | | | | | | | - Angela Schulz
- Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Child and Adolescent Health (DZKJ), partner site Hamburg, Hamburg, Germany
| | - Simon Dulz
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jeltsch BM, Hanson JVM, Füglistaler J, Heyard R, Sisera L, Wehrle FM, Hagmann CF, Fauchère JC, Gerth-Kahlert C. The Effect of Perinatal High-Dose Erythropoietin on Retinal Structural and Vascular Characteristics in Children Born Preterm. Am J Ophthalmol 2024; 266:264-273. [PMID: 38880371 DOI: 10.1016/j.ajo.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To study the long-term effects of perinatal high-dose recombinant human erythropoietin (rhEPO) on macular structural and vascular development in preterm children. DESIGN Randomized, double-blind clinical trial follow-up plus cohort study. METHODS Setting: Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. STUDY POPULATION extremely or very preterm born children aged 7-15 years from an ongoing neuropediatric study (EpoKids). These had been previously randomized to receive either high-dose rhEPO or placebo perinatally. INCLUSION CRITERIA participation in the EpoKids Study, written informed consent (IC). EXCLUSION CRITERIA previous ocular trauma or surgery; retinal or developmental disease unrelated to prematurity. Term-born children of comparable age were enrolled as a healthy control (HC) group. INCLUSION CRITERIA term birth, IC. EXCLUSION CRITERIA any ocular or visual abnormality, high refractive error. Examiners were blinded regarding intervention status until completion of all analyses. (Participants/guardians remain blinded). OBSERVATION PROCEDURES Spectral-domain OCT scans (Heidelberg Spectralis system) and OCTA imaging (Zeiss PlexElite 9000) were obtained. Ophthalmological and orthoptic examinations excluded ocular comorbidities. MAIN OUTCOME MEASURES OCT (central retinal thickness, CRT; total macular volume, TMV), superficial plexus OCTA (foveal avascular zone, FAZ; vessel density, VD; vessel length density, VLD) parameters and foveal hypoplasia grade according to published criteria. RESULTS Macular vessel density parameters (VD and VLD) were significantly lower (p =0.015, CI-95: 0.01 to 0.06 and p=0.015, CI-95: 0.74 to 3.64) in the EPO group (n= 52) when compared to placebo (n=35). No other significant differences were observed between the EPO and placebo group. When comparing the intervention subgroups to HC we found six significant differences in OCT and OCTA parameters (FAZ, VD, VLD and CRT comparing HC and EPO group; FAZ and CRT when comparing HC and placebo group). CONCLUSIONS Early high-dose rhEPO in infants born extremely or very preterm affects macular vessel density parameters compared to placebo. Premature birth (regardless of intervention status) affects retinal structure and vascular development. Our findings on macular vascular development do not contraindicate the administration of early high-dose EPO in preterm infants. For further understanding of the role of EPO on macular development and its clinical significance, future studies are needed.
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Affiliation(s)
- Brida M Jeltsch
- From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - James V M Hanson
- From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Jonas Füglistaler
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute (J.F., R.H.), University of Zurich, Zurich, Switzerland
| | - Rachel Heyard
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute (J.F., R.H.), University of Zurich, Zurich, Switzerland
| | - Lorena Sisera
- From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Flavia M Wehrle
- Department of Neonatology and Pediatric Intensive Care (F.M.W., C.F.H), University Children's Hospital Zurich, Zurich, Switzerland
| | - Cornelia F Hagmann
- Department of Neonatology and Pediatric Intensive Care (F.M.W., C.F.H), University Children's Hospital Zurich, Zurich, Switzerland
| | - Jean-Claude Fauchère
- Department of Neonatology (J-C.F.), University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Christina Gerth-Kahlert
- From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland.
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Nassisi M, Mainetti C, Sperti A, Galmozzi G, Aretti A, Leone G, Nicotra V, Grilli F, Rinaldi B, Natacci F, Bedeschi MF, Viola F. Optical coherence tomography angiography findings in Williams-Beuren syndrome. Graefes Arch Clin Exp Ophthalmol 2024; 262:1131-1140. [PMID: 38032380 DOI: 10.1007/s00417-023-06323-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/23/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Williams-Beuren syndrome (WBS) is a rare genetic disease characterized by psychomotor delay, cardiovascular, musculoskeletal, and endocrine problems. Retinal involvement, which is not well characterized, has also been described. The purpose of this cross-sectional study is to describe the characteristics in optical coherence tomography (OCT) and OCT-angiography (OCTA) of patients with WBS. METHODS We included patients with WBS confirmed by genetic analysis. The patients underwent OCT (30° × 25°, 61 B-scans) and OCTA (10° × 10° and 20° × 20°) examinations, all centered on the. Data on retinal thickness (total, inner and outer layers) and foveal morphology on OCT and vessel and perfusion density in OCTA (VD and PD, respectively) were collected. These data were compared with an age-matched control group. RESULTS 22 eyes of 22 patients with WBS (10 females, mean age 31.5 years) were included. Retinal thickness (and specifically inner retinal layers) in OCT was significantly reduced in all sectors (central, parafoveal, and perifoveal) compared to the control group (p < 0.001 in all sectors). Fovea in WBS eyes was broader and shallower than controls. The PD and VD in both 10 and 20 degrees of fields in OCTA was significantly reduced in patients with WBS, in all vascular plexa (all p < 0.001). CONCLUSIONS This study is the first to quantify and demonstrate retinal structural and microvascular alterations in patients with WBS. Further studies with longitudinal data will reveal the potential clinical relevance of these alterations.
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Affiliation(s)
- Marco Nassisi
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy.
| | - Claudia Mainetti
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Sperti
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
| | - Guido Galmozzi
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
| | - Andrea Aretti
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
| | - Gaia Leone
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valeria Nicotra
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federico Grilli
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Berardo Rinaldi
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Natacci
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Francesca Bedeschi
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Viola
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
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Downes RA, Rachitskaya AV. Ophthalmic sequelae of prematurity in late childhood and adulthood: A review. Clin Exp Ophthalmol 2024; 52:355-364. [PMID: 38334000 DOI: 10.1111/ceo.14358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/07/2023] [Accepted: 01/03/2024] [Indexed: 02/10/2024]
Abstract
Advances in the care of premature infants have resulted in unprecedented rates of survival of these infants into adulthood, including those born at very low gestational ages. Ophthalmologists have historically followed premature infants to assess for the presence of and potential need for treatment of retinopathy of prematurity. However, a growing body of literature suggests that the ophthalmic consequences of prematurity extended beyond retinopathy of prematurity and that ophthalmic sequelae of prematurity can endure through adulthood even among formerly preterm adults who were never diagnosed with retinopathy of prematurity. These abnormalities can include a range of both anterior segment and posterior segment sequelae, including higher rates of corneal aberrations, ocular hypertension, strabismus, foveal anomalies, and retinal tears and detachments. This review aims to summarise this literature, underscoring the importance of lifelong examinations and regular monitoring for these complications among adults who were born prematurely.
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Affiliation(s)
- Rachel A Downes
- Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Anwar S, Nath M, Patel A, Tyradellis S, Gottlob I, Proudlock FA. USE OF HAND-HELD OPTICAL COHERENCE TOMOGRAPHY DURING RETINOPATHY OF PREMATURITY SCREENING DEMONSTRATES AN INCREASED OUTER RETINA FROM EARLY POSTMENSTRUAL AGE IN PRETERM INFANTS WITH RETINOPATHY OF PREMATURITY. Retina 2024; 44:306-315. [PMID: 37824817 PMCID: PMC10807749 DOI: 10.1097/iae.0000000000003957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE To identify structural markers of active retinopathy of prematurity (ROP) in foveal and parafoveal retinal layers using hand-held optical coherence tomography. METHODS Hand-held optical coherence tomography images (n = 278) were acquired from a prospective mixed cross-sectional longitudinal observational study of 87 participants (23-36 weeks gestational age; n = 30 with ROP, n = 57 without ROP) between 31 and 44 weeks postmenstrual age excluding treated ROP and features of cystoid macular edema. Six retinal layer thicknesses from the fovea to the parafovea were analyzed at five locations up to 1,000 µ m, temporally and nasally. RESULTS The mean outer retinal thickness during active ROP increased at the fovea and parafovea from postmenstrual age 33 weeks to 39 weeks ( P < 0.001), whereas the parafoveal inner nuclear layer and retinal nerve fiber layer reduced ( P < 0.001). Outer retinal thickness at the fovea from 33 weeks to 39 weeks postmenstrual age was consistently thicker in infants with ROP across all levels of prematurity (gestational age). CONCLUSION Increased foveal and parafoveal outer retina measured using hand-held optical coherence tomography shows potential as a marker for ROP screening.
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Affiliation(s)
- Samira Anwar
- University of Leicester Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, Leicester, United Kingdom
- Department of Ophthalmology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; and
| | - Mintu Nath
- Institute of Applied Health Sciences, The University of Aberdeen, Aberdeen, United Kingdom
| | - Aarti Patel
- University of Leicester Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, Leicester, United Kingdom
| | - Straton Tyradellis
- Department of Ophthalmology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; and
| | - Irene Gottlob
- University of Leicester Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, Leicester, United Kingdom
| | - Frank A. Proudlock
- University of Leicester Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, Leicester, United Kingdom
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Yeh WH, Ju YJ, Hsieh TH, Liu YT. Effects of grating stimulation on vision in individuals with amblyopia: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2024; 262:395-410. [PMID: 37306731 DOI: 10.1007/s00417-023-06142-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023] Open
Abstract
PURPOSE To investigate the effects of Cambridge Stimulator with grating element stimulation on visual acuity (VA), grating acuity (GA), and contrast sensitivity (CS) in patients with amblyopia. METHODS Three electronic databases (PubMed, Embase, and Cochrane Library) were searched for studies published from January 1970 to November 2022. The searched studies were reviewed and extracted independently by two authors. The included studies were evaluated by the Cochrane risk of bias. A meta-analysis calculating Hedges' g effect-size metric with 95% confidence intervals using random-effects DerSimonian-Laird model was employed. Heterogeneity was estimated using I2 statistics. Outcomes of interest included VA, GA, and CS. RESULTS A total of 1221 studies were identified. Twenty-four studies including 900 subjects met the inclusion criteria. The outcome measure of all visual indexes (VA: Hedges' g of - 0.43, 95% CI = - 0.81 to - 0.05, I2 = 86%, p = 0.02; GA: Hedges' g of 3.79, 95% CI = 1.05 to 6.54, I2 = 98%, p = 0.01; CS: Hedges' g of 0.64, 95% CI = 0.19 to 1.09, I2 = 41%, p = 0.00) significantly favored in the grating group. CONCLUSIONS Grating stimulation may be a positive help for visual functions in patients with amblyopia. The effects of grating stimulation on VA and CS appear to be opposite. This study is registered with www.crd.york.ac.uk/prospero/ (CRD42022366259).
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Affiliation(s)
- Wen-Hsiu Yeh
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, 821, Taiwan.
| | - Ya-Ju Ju
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, 821, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Tzu-Han Hsieh
- Department of Ophthalmology, Far-Eastern Memorial Hospital, New Taipei City, 220, Taiwan
| | - Yu-Ting Liu
- Department of Medical Science Industries, Chang Jung Christian University, Tainan, 711, Taiwan
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10
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Domdei N, Ameln J, Gutnikov A, Witten JL, Holz FG, Wahl S, Harmening WM. Cone Density Is Correlated to Outer Segment Length and Retinal Thickness in the Human Foveola. Invest Ophthalmol Vis Sci 2023; 64:11. [PMID: 38064229 PMCID: PMC10709802 DOI: 10.1167/iovs.64.15.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Purpose Assessment of the relationship between in vivo foveolar cone density, cone outer segment length (OSL), and foveal retinal thickness (RT). Methods Foveolar cone density maps covering the central ±300 µm of the retina were derived from adaptive optics scanning laser ophthalmoscopy images. The corresponding maps of foveal cone OSL and RT were derived from high-resolution optical coherence tomography volume scans. Alignment of the two-dimensional maps containing OSL and RT with the cone density map was achieved by placing the location of maximum OSL on the cone density centroid (CDC). Results Across 10 participants (27 ± 9 years; 6 female), cone density at the CDC was found to be between 147,038 and 215,681 cones/mm². The maximum OSL and minimum RT were found to lie between 31 and 40, and 193 and 226 µm, respectively. A significant correlation was observed between cone density at the CDC and maximum OSL (P = 0.001), as well as the minimal RT (P < 0.05). Across all participants, the best fit for the relationship between normalized cone density and normalized OSL within the central 300 µm was given by a quadratic function. Conclusions Using optical coherence tomography-derived measurements of OSL enables to estimate CDC cone density and two-dimensional foveal cone density maps for example in patient eyes unsuitable for adaptive optics imaging. Furthermore, the observation of a fixed relationship between the normalized OSL and cone density points to a conserved mechanism shaping the foveal pit.
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Affiliation(s)
- Niklas Domdei
- Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Julius Ameln
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | - Jenny L Witten
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Siegfried Wahl
- Carl Zeiss Vision International GmbH, Aalen, Germany
- Institute for Ophthalmic Research, Eberhard Karls University Tübingen, Tübingen, Germany
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11
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Pétursdóttir D, Åkerblom H, Holmström G, Larsson E. Central macular morphology and optic nerve fibre layer thickness in young adults born premature and screened for retinopathy of prematurity. Acta Ophthalmol 2023. [PMID: 37991127 DOI: 10.1111/aos.15814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/08/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To investigate central retinal morphology and optic retinal nerve fibre layer (RNFL) in prematurely born young adults and compare to term born controls. MATERIALS AND METHODS The participants were 59 prematurely born individuals, with a birthweight ≤1.500 g, and 44 term born controls, all 25-29 years of age. Visual acuity (VA) and contrast sensitivity (CS) were assessed. The retinal macular thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness and RNFL thickness were assessed with Cirrus optical coherence tomography (OCT). RESULTS Central macular thickness was increased (mean 26.7 μm) in prematurely born individuals compared to controls. The macular GC-IPL was thinner (mean 3.84 μm), also when excluding those with previous retinopathy of prematurity (ROP) and those with neurological complications. Gestational age at birth and previous treatment of ROP were risk factors for a thicker macula, however, not for reduced GC-IPL. The average peripapillary RNFL was thinner (mean 4.61 μm) in the prematurely born individuals, also when excluding those with previous ROP and/or neurological complications. Within the prematurely born group, treated ROP was correlated with increased average RNFL. Further, both better VA and CS were associated with thinner optic nerve RNFL and thicker average GC-IPL. CONCLUSION Macular and optic nerve morphology were influenced by premature birth as assessed with OCT in adult individuals. Gestational age at birth and treatment for ROP seemed to affect central macular thickness, and treated ROP affected the peripapillary RNFL. Thus, retinal sequelae remained in adulthood.
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Affiliation(s)
- Dýrleif Pétursdóttir
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
- Department of Ophthalmology, Faculty of Medicine, National University Hospital, University of Iceland, Reykjavík, Iceland
| | - Hanna Åkerblom
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research Västmanland, Hospital of Västmanland, Västerås, Sweden
| | - Gerd Holmström
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Eva Larsson
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
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12
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Mangalesh S, Toth CA. Preterm infant retinal OCT markers of perinatal health and retinopathy of prematurity. Front Pediatr 2023; 11:1238193. [PMID: 37808559 PMCID: PMC10551634 DOI: 10.3389/fped.2023.1238193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
The increasing survival of preterm infants has led to the importance of improving long-term outcomes associated with preterm birth. Antenatal and perinatal insults not only impact mortality, but also long-term disability. While in the intensive care nursery, preterm infants are also exposed to various stressors that lead to long-term cognitive deficits. It is therefore critical to identify early, low-stress, non-invasive biomarkers for preterm infant health. Optical coherence tomography (OCT) is a powerful imaging modality that has recently been adapted to the infant population and provides noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside with low stress relative to conventional examination. In this review we delve into discussing the associations between preterm systemic health factors and OCT-based retinal findings and their potential contribution to the development of non-invasive biomarkers for infant health and for retinopathy of prematurity (ROP).
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Affiliation(s)
| | - Cynthia A. Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States
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13
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Seely KR, McCall M, Ying GS, Prakalapakorn SG, Freedman SF, Toth CA. Ocular Pigmentation Impact on Retinal Versus Choroidal Optical Coherence Tomography Imaging in Preterm Infants. Transl Vis Sci Technol 2023; 12:7. [PMID: 37410471 PMCID: PMC10337806 DOI: 10.1167/tvst.12.7.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/01/2023] [Indexed: 07/07/2023] Open
Abstract
Purpose To evaluate the association of fundus pigmentation with the visibility of retinal versus choroidal layers on optical coherence tomography (OCT) in preterm infants. Methods For infants enrolled in BabySTEPS, ophthalmologists recorded fundus pigmentation (blond, medium, or dark) at the first retinopathy of prematurity (ROP) examination. Bedside OCT imaging was performed at each examination, and a masked grader evaluated all OCT scans from both eyes of each infant for visibility (yes/no) of all retinal layers and of the chorio-scleral junction (CSJ). Multivariable logistic regression was used to assess associations between fundus pigmentation and visibility of all retinal layers and CSJ, controlling for potential confounders (i.e., birth weight, gestational age, sex, OCT system, pupil size, and postmenstrual age at imaging). Results Among 114 infants (mean birth weight, 943 grams; mean gestational age, 27.6 weeks), 43 infants (38%) had blond, 56 infants (49%) had medium, and 15 infants (13%) had dark fundus pigmentation. Of 1042 scans, all retinal layers were visible in 977 (94%) and CSJ in 895 (86%). Pigmentation was not associated with retinal layer visibility (P = 0.49), but medium and dark pigmentation were associated with decreased CSJ visibility (medium: odds ratio [OR] = 0.34, P = 0.001; dark: OR = 0.24, P = 0.009). For infants with dark pigmentation, retinal layer visibility increased (OR = 1.87 per week; P ≤ 0.001) and CSJ visibility decreased (OR = 0.78 per week; P = 0.01) with increasing age. Conclusions Although fundus pigmentation was not associated with the visibility of all retinal layers on OCT, darker pigmentation decreased CSJ visibility, and this effect increased with age. Translational Relevance The ability of bedside OCT to capture retinal layer microanatomy in preterm infants, regardless of fundus pigmentation, may represent an advantage over fundus photography for ROP telemedicine.
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Affiliation(s)
- Kai R. Seely
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | - Michelle McCall
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | - Gui-Shuang Ying
- Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | - S. Grace Prakalapakorn
- Department of Ophthalmology, Duke University, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Sharon F. Freedman
- Department of Ophthalmology, Duke University, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Cynthia A. Toth
- Department of Ophthalmology, Duke University, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - for the BabySTEPS Group
- Department of Ophthalmology, Duke University, Durham, NC, USA
- Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
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14
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Kubsad D, Ohan MA, Wu JG, Cabrera MT. Vitreoretinal biomarkers of retinopathy of prematurity using handheld optical coherence tomography: a review. Front Pediatr 2023; 11:1191174. [PMID: 37325353 PMCID: PMC10264674 DOI: 10.3389/fped.2023.1191174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Retinopathy of prematurity (ROP) is caused by abnormal retinal vascularization in premature infants that has the potential for severe long-term vision impairment. Recent advancements in handheld optical coherence tomography (OCT) have enabled noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside. The use of handheld OCT devices in the diagnosis of ROP in premature infants has furthered our understanding of disease state and progression. This review discusses the known and novel biomarkers of ROP severity in premature infants identified through handheld OCT and potential for future directions.
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Affiliation(s)
- Deepika Kubsad
- University of Washington School of Medicine, Seattle, WA, United States
| | - Masis A. Ohan
- University of Washington School of Medicine, Seattle, WA, United States
| | - Jolan G. Wu
- Department of Ophthalmology, University of Washington, Seattle, WA, United States
| | - Michelle T. Cabrera
- Department of Ophthalmology, University of Washington, Seattle, WA, United States
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, WA, United States
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15
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Ghassemi F, Salari F, Hatami V, Bazvand F, Shamouli H, Mohebbi M, Sabour S. Quantitative Analysis of Inner, Middle, and Outer Retinal Thickness by Optical Coherence Tomography in Children and Adolescents. J Curr Ophthalmol 2023; 35:182-189. [PMID: 38250483 PMCID: PMC10795818 DOI: 10.4103/joco.joco_141_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 01/23/2024] Open
Abstract
Purpose To describe the variance of inner, middle, and outer retinal layer thicknesses (IRT, MRT, and ORT) at the macular area in children and adolescents with normal eyes in different age groups. Methods This cross-sectional study enrolled subjects aged 5-18 years with normal eyes. The macula was scanned by optical coherence tomography (6 mm × 6 mm AngioScan-Optovue). Four age groups were defined (≤7, 7-10, 11-14, and ≥14 years). The influences of age and gender were analyzed. Results One hundred and thirty-nine eyes of 69 subjects with a mean age of 10.92 ± 3.51 years were registered. The mean whole macular thickness (MT) was 297.32 ± 11.05 in males and 303.197 ± 13.32 in females (P = 0.01, t-test). The MT in each aging group was 301.47 ± 2.5, 295.53 ± 1.71, 300.81 ± 2.12, and 298.6 ± 1.87, subsequently (P = 0.17, analysis of variance test). Significant differences were found between the sexes at the perifoveal area and mainly in IRT. No correlation between eyes was noted. We observed that the RT fluctuates during growth and that gender has some influence on the evolution of RT. IRT and MRT changed reciprocally in all macular areas, whereas ORT expanded in all age groups of children and adolescents. Conclusions No subsegmental retinal thickness difference between eyes was observed in pediatric groups in this study, while gender had some influence on perifoveal IRT. Despite the fact that this study is not a longitudinal study, we can get some insight into the developmental changes in retinal thickness and its clinical applications in children and adolescents.
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Affiliation(s)
- Fariba Ghassemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Salari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Hatami
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bazvand
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Shamouli
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mohebbi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Sabour
- Department of Clinical Epidemiology, School of Health and Safety, Safety Promotion and Injury Prevention Research Center, Tehran, Iran
- Department of Clinical Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Himmelberg MM, Tünçok E, Gomez J, Grill-Spector K, Carrasco M, Winawer J. Comparing retinotopic maps of children and adults reveals a late-stage change in how V1 samples the visual field. Nat Commun 2023; 14:1561. [PMID: 36944643 PMCID: PMC10030632 DOI: 10.1038/s41467-023-37280-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Abstract
Adult visual performance differs with angular location -it is better for stimuli along the horizontal than vertical, and lower than upper vertical meridian of the visual field. These perceptual asymmetries are paralleled by asymmetries in cortical surface area in primary visual cortex (V1). Children, unlike adults, have similar visual performance at the lower and upper vertical meridian. Do children have similar V1 surface area representing the upper and lower vertical meridian? Using MRI, we measure the surface area of retinotopic maps (V1-V3) in children and adults. Many features of the maps are similar between groups, including greater V1 surface area for the horizontal than vertical meridian. However, unlike adults, children have a similar amount of V1 surface area representing the lower and upper vertical meridian. These data reveal a late-stage change in V1 organization that may relate to the emergence of the visual performance asymmetry along the vertical meridian by adulthood.
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Affiliation(s)
- Marc M Himmelberg
- Department of Psychology, New York University, New York, NY, 10003, USA.
- Center for Neural Science, New York University, New York, NY, 10003, USA.
| | - Ekin Tünçok
- Department of Psychology, New York University, New York, NY, 10003, USA
| | - Jesse Gomez
- Princeton Neuroscience Institute, Princeton University, Princeton, NJ, 08540, USA
| | - Kalanit Grill-Spector
- Department of Psychology, Stanford University, Stanford, CA, 94305, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, 94305, USA
| | - Marisa Carrasco
- Department of Psychology, New York University, New York, NY, 10003, USA
- Center for Neural Science, New York University, New York, NY, 10003, USA
| | - Jonathan Winawer
- Department of Psychology, New York University, New York, NY, 10003, USA
- Center for Neural Science, New York University, New York, NY, 10003, USA
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17
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Foveal photoreceptor disruption in ocular diseases: An optical coherence tomography-based differential diagnosis. Surv Ophthalmol 2023:S0039-6257(23)00046-2. [PMID: 36934831 DOI: 10.1016/j.survophthal.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023]
Abstract
Fovea centralis, located at the center of the macula, is packed with cone photoreceptors and is responsible for central visual acuity. Isolated foveal photoreceptor disruption may occur in a variety of hereditary, degenerative, traumatic, and toxic chorioretinal diseases. These have been known previously by multiple synonyms including macular microhole, foveal spot, and outer foveal microdefects. A common clinical feature underlying these conditions is the presence of apparently normal fovea or subtle hypopigmented lesion at the foveal or juxtafoveal area. A detailed history along with high-resolution optical coherence tomography is often helpful to derive a conclusive diagnosis in majority of these cases. Focal photoreceptor disruption usually involves loss or rarefaction of ellipsoid/interdigitation zone, either in isolation or associated with external limiting membrane or retinal pigment epithelium disruption in the fovea. Vitreomacular interface (VMI) disorders including vitreomacular traction, posterior vitreous detachment, epiretinal membrane, and impending macular hole possibly remain the most common cause. Retinal dystrophies such as cone dystrophy, occult macular dystrophy, and achromatopsia may present with diminution of vision and normal appearing fundus in a younger age group. Other causes include photic retinopathy (e.g., from a history of sun gazing, or laser pointer exposure), blunt trauma, drug exposure (e.g., poppers maculopathy or tamoxifen retinopathy), and acute retinal pigment epitheliopathy (ARPE). Visual prognosis depends on the underlying etiology with complete recovery common in the subset of patients with VMI, and ARPE, whereas persistent outer retinal defects are the rule in other conditions. We discuss the differential diagnoses that lead to isolated foveal photoreceptor defects. Identifying and understanding the underlying disease processes that cause foveal photoreceptor disruption may help predict visual prognosis.
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18
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Garcia-Medina JJ, Bascuñana-Mas N, Sobrado-Calvo P, Gomez-Molina C, Rubio-Velazquez E, De-Paco-Matallana M, Zanon-Moreno V, Pinazo-Duran MD, Del-Rio-Vellosillo M. Macular Anatomy Differs in Dyslexic Subjects. J Clin Med 2023; 12:jcm12062356. [PMID: 36983356 PMCID: PMC10057708 DOI: 10.3390/jcm12062356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The macula, as the central part of the retina, plays an important role in the reading process. However, its morphology has not been previously studied in the context of dyslexia. In this research, we compared the thickness of the fovea, parafovea and perifovea between dyslexic subjects and normal controls, in 11 retinal segmentations obtained by optical coherence tomography (OCT). With this aim, we considered the nine sectors of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid and also summarized data from sectors into inner ring subfield (parafovea) and outer ring subfield (perifovea). The thickness in all the four parafoveal sectors was significantly thicker in the complete retina, inner retina and middle retina of both eyes in the dyslexic group, as well as other macular sectors (fovea and perifovea) in the inner nuclear layer (INL), inner plexiform layer (IPL), IPL + INL and outer plexiform layer + outer nuclear layer (OPL + ONL). Additionally, the inner ring subfield (parafovea), but not the outer ring subfield (perifovea), was thicker in the complete retina, inner retina, middle retina (INL + OPL + ONL), OPL + ONL, IPL + INL and INL in the dyslexic group for both eyes. In contrast, no differences were found between the groups in any of the sectors or subfields of the outer retina, retinal nerve fiber layer, ganglion cell layer or ganglion cell complex in any eye. Thus, we conclude from this exploratory research that the macular morphology differs between dyslexic and normal control subjects, as measured by OCT, especially in the parafovea at middle retinal segmentations.
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Affiliation(s)
- Jose Javier Garcia-Medina
- Department of Ophthalmology, Optometry, Otolaryngology and Pathology, University of Murcia, 30100 Murcia, Spain
- General University Hospital Reina Sofia, 30003 Murcia, Spain
- General University Hospital Morales Meseguer, 30008 Murcia, Spain
- Ophthalmic Research Unit "Santiago Grisolia", 46017 Valencia, Spain
- Spanish Net of Ophthalmic Pathology OFTARED RD16/0008/0022, Institute of Health Carlos III, 28029 Madrid, Spain
- Spanish Net of Inflammatory Diseases RICORS, Institute of Health Carlos III, 28029 Madrid, Spain
| | | | - Paloma Sobrado-Calvo
- Department of Ophthalmology, Optometry, Otolaryngology and Pathology, University of Murcia, 30100 Murcia, Spain
- General University Hospital Reina Sofia, 30003 Murcia, Spain
- Spanish Net of Ophthalmic Pathology OFTARED RD16/0008/0022, Institute of Health Carlos III, 28029 Madrid, Spain
- Spanish Net of Inflammatory Diseases RICORS, Institute of Health Carlos III, 28029 Madrid, Spain
| | - Celia Gomez-Molina
- General University Hospital Reina Sofia, 30003 Murcia, Spain
- General University Hospital Morales Meseguer, 30008 Murcia, Spain
| | | | | | - Vicente Zanon-Moreno
- Ophthalmic Research Unit "Santiago Grisolia", 46017 Valencia, Spain
- Spanish Net of Ophthalmic Pathology OFTARED RD16/0008/0022, Institute of Health Carlos III, 28029 Madrid, Spain
- Spanish Net of Inflammatory Diseases RICORS, Institute of Health Carlos III, 28029 Madrid, Spain
- Faculty of Health Sciences, International University of Valencia, 46002 Valencia, Spain
| | - Maria Dolores Pinazo-Duran
- Ophthalmic Research Unit "Santiago Grisolia", 46017 Valencia, Spain
- Spanish Net of Ophthalmic Pathology OFTARED RD16/0008/0022, Institute of Health Carlos III, 28029 Madrid, Spain
- Spanish Net of Inflammatory Diseases RICORS, Institute of Health Carlos III, 28029 Madrid, Spain
- Cellular and Molecular Ophthalmobiology Group, Surgery Department, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Monica Del-Rio-Vellosillo
- University Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
- Department of Surgery, Obstetrics and Gynecology and Pediatrics, University of Murcia, 30100 Murcia, Spain
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19
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Mao J, Chen Y, Fang Y, Shao Y, Xiang Z, Li H, Zhao S, Chen Y, Shen L. Clinical characteristics and mutation spectrum in 33 Chinese families with familial exudative vitreoretinopathy. Ann Med 2022; 54:3286-3298. [PMID: 36411543 PMCID: PMC9704097 DOI: 10.1080/07853890.2022.2146744] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To explore the clinical manifestations and search for the variants of six related genes (LRP5, FZD4, TSPAN12, NDP, KIF11 and ZNF408) in Chinese patients with familial exudative vitreoretinopathy (FEVR), and investigate the correlation between the genetic variants and the clinical characteristics. PATIENTS AND METHODS Clinical data, including the retinal artery angle, acquired from wide-field fundus imaging, structural and microvascular features of the retina obtained from optical coherence tomography (OCT) and OCT angiography (OCTA) were collected from 33 pedigrees. Furthermore, mutation screening was performed. Variants filtering, bioinformatics analysis and Sanger sequencing were conducted to verify the variants. RESULTS Twenty-one variants were successfully detected in 16 of 33 families, of which 10 variants were newly identified. The proportion of variants in LRP5, FZD4, TSPAN12, NDP and KIF11 was 38.1% (8/21), 33.3% (7/21), 19.1% (4/21), 4.8% (1/21) and 4.8% (1/21), respectively. Three new variants were considered to be pathogenic or likely pathogenic. The FEVR group tended to exhibit a smaller retinal artery angle, higher incidence of foveal hypoplasia and lower vascular density compared to the control group. Patients who harboured variants of FZD4 exhibited greater severity of FEVR than those with LRP5 variants. However, those who harboured LRP5 variants tended to possess lower foveal vascular density. CONCLUSIONS Six known pathogenic genes were screened in 33 pedigrees with FEVR in our study, which revealed 10 novel variants. These findings enrich the clinical features and mutation spectrum in Chinese patients with FEVR, revealing the genotype-phenotype relationship, and contributing to the diagnosis and treatment of the disease.Key messagesWe identified 21 variants in 5 genes (LRP5, FZD4, TSPAN12, NDP and KIF11) associated with FEVR, 10 of which are novel (three were pathogenic or likely pathogenic).The proportion of variants was the highest for the LRP5 gene.FZD4 variants may be responsible for greater FEVR severity than LRP5 variants.
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Affiliation(s)
- Jianbo Mao
- Department of Ophthalmology, Center for Rehabilitation Medicine, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, PR China.,Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yijing Chen
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yuyan Fang
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yirun Shao
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Ziyi Xiang
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Hanxiao Li
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Shixin Zhao
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yiqi Chen
- Department of Ophthalmology, Center for Rehabilitation Medicine, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, PR China.,Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Lijun Shen
- Department of Ophthalmology, Center for Rehabilitation Medicine, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, PR China.,Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
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20
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Macular thickness variation and interocular symmetry by gestational age in preterm school-age children. J AAPOS 2022; 26:311.e1-311.e8. [PMID: 36328300 DOI: 10.1016/j.jaapos.2022.08.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To determine changes in macular thickness profile according to gestational age (GA) and to assess interocular symmetry in the macula of children born very preterm. METHODS In this cross-sectional study of preterm (n = 106) and term-born (n = 49) children 5-8 years of age at time of examination, optical coherence tomography was used to measure macula thickness as described in the ETDRS study. Statistical analyses included stratified and multivariable analyses. RESULTS Foveal minimum thickness increased with decreasing GA (P for trend, <0.001; 254.7 ± 32.8 μm for children born at 24-25 weeks and 193.2 ± 32.8 μm in term-born children). Inner and outer area thickness differed for term and preterm children, but did not vary with the degree of prematurity (inner area, 267.0 ± 11.0 μm for 24-25 weeks' GA and 305.4 ± 11.8 μm for term children [P < 0.01]; outer ring, 305.5 ± 10.4 μm in extreme preterm and 271.0 ± 10.4 μm in term children [P < 0.01]). Interocular asymmetry in preterm children was not significant for most areas; the largest interocular difference was found in the central zone (16.3 ±16.6 μm). CONCLUSIONS In our study cohort, children born very preterm examined at school age compared to term born children had greater central thickness with decreased foveal pit, decreased inner ring, and increased thickness of the outer ring. They did not show greater interocular asymmetry.
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Hanyu T, Ueki S, Hasegawa Y, Kiyokawa M, Fukuchi T. Posterior microphthalmos with achievement of good visual acuity and disappearance of papillomacular retinal folds: a case report. BMC Ophthalmol 2022; 22:424. [PMID: 36344972 PMCID: PMC9639268 DOI: 10.1186/s12886-022-02648-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
Background Posterior microphthalmos (PM) is a rare condition with poor visual prognosis even after amblyopia treatment. We report a case of PM with achievement of good visual acuity and disappearance of papillomacular retinal folds (PFs) over a period of 7 years. Case presentation A girl aged 3 years and 5 months was referred to our hospital, after poor visual acuity was identified at a medical checkup for 3-year-olds. She had severe spherical hyperopia: + 17.25 D in the right eye (RE) and + 18 D in the left eye (LE). Her corrected visual acuity was 20/200 in the RE and 20/250 in the LE. PFs were observed in both eyes on optical coherence tomography (OCT), and the diagnosis of PM was made based on the normal corneal diameter and anterior chamber depth. During the course of the disease, a gradual decrease in the height of the PFs was observed on OCT. The corrected visual acuity at age 10 years was 20/20 in the RE and 20/25 in the LE. Conclusions The visual prognosis of PM is poor, and only one case with good visual acuity has been reported in the literature. The patient in the present case not only developed good visual acuity, but also showed improvement in macular morphology, which was not noted in previous reports. Early diagnosis of PM and early amblyopia treatment is important for the visual development in PM.
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Affiliation(s)
- Takako Hanyu
- grid.260975.f0000 0001 0671 5144Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi-Dori 1-757, Chuo-Ku, Niigata, 951-8510 Japan ,Hanyu Clinic, Igarashi-Higashi 1-1-15, Nishi-Ku, Niigata, 950-2045 Japan
| | - Satoshi Ueki
- grid.260975.f0000 0001 0671 5144Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi-Dori 1-757, Chuo-Ku, Niigata, 951-8510 Japan
| | - Yukari Hasegawa
- grid.260975.f0000 0001 0671 5144Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi-Dori 1-757, Chuo-Ku, Niigata, 951-8510 Japan
| | - Megumi Kiyokawa
- grid.260975.f0000 0001 0671 5144Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi-Dori 1-757, Chuo-Ku, Niigata, 951-8510 Japan ,Toshimi Eye Clinic, Katsubogawa 1-1-12, Sanjo City, Niigata, 955-0056 Japan
| | - Takeo Fukuchi
- grid.260975.f0000 0001 0671 5144Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi-Dori 1-757, Chuo-Ku, Niigata, 951-8510 Japan
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22
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The OCT angular sign of Henle fiber layer (HFL) hyperreflectivity (ASHH) and the pathoanatomy of the HFL in macular disease. Prog Retin Eye Res 2022:101135. [DOI: 10.1016/j.preteyeres.2022.101135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022]
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23
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Ferro Desideri L, Rutigliani C, Corazza P, Nastasi A, Roda M, Nicolo M, Traverso CE, Vagge A. The upcoming role of Artificial Intelligence (AI) for retinal and glaucomatous diseases. JOURNAL OF OPTOMETRY 2022; 15 Suppl 1:S50-S57. [PMID: 36216736 PMCID: PMC9732476 DOI: 10.1016/j.optom.2022.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
In recent years, the role of artificial intelligence (AI) and deep learning (DL) models is attracting increasing global interest in the field of ophthalmology. DL models are considered the current state-of-art among the AI technologies. In fact, DL systems have the capability to recognize, quantify and describe pathological clinical features. Their role is currently being investigated for the early diagnosis and management of several retinal diseases and glaucoma. The application of DL models to fundus photographs, visual fields and optical coherence tomography (OCT) imaging has provided promising results in the early detection of diabetic retinopathy (DR), wet age-related macular degeneration (w-AMD), retinopathy of prematurity (ROP) and glaucoma. In this review we analyze the current evidence of AI applied to these ocular diseases, as well as discuss the possible future developments and potential clinical implications, without neglecting the present limitations and challenges in order to adopt AI and DL models as powerful tools in the everyday routine clinical practice.
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Affiliation(s)
- Lorenzo Ferro Desideri
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
| | | | - Paolo Corazza
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy
| | | | - Matilde Roda
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - Massimo Nicolo
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy
| | - Carlo Enrico Traverso
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy
| | - Aldo Vagge
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy
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24
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Structural impact of arrested foveal development in children born extremely preterm without ROP at 6.5 years of age. Eye (Lond) 2022:10.1038/s41433-022-02237-6. [DOI: 10.1038/s41433-022-02237-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/02/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Objectives
To characterize changes of foveal topography and microstructure of persisting foveal immaturity at 6.5 years of age in children born extremely preterm without retinopathy of prematurity (EPT-NoROP).
Methods
Images from previous optical coherence tomography examinations of 37 EPT-NoROP and 92 control eyes were selected from a regional cohort of the EXPRESS (Extremely Preterm Infants in Sweden) study. Thickness of ganglion cell + inner plexiform layer (GCL+), outer nuclear layer (ONL), retinal thickness (RT) at the foveal centre (FC), foveal depth (FD) and RT at the foveal rim were evaluated.
Results
Layer thickness of GCL+, ONL and RT was increased at FC in the EPT-NoROP group. More than two-thirds had thickness values above the control limit (control mean +2 SD) at FC (GCL + 68%, ONL 76%, and RT 68%), and 50% had reduced FD compared to controls. All parameters showed a high correlation within the EPT-NoROP group, whereas no or weaker correlation was seen in control eyes. The EPT-NoROP sub-groups, divided based on the control limit, did not differ in terms of associated factors such as gestational age, birth weight, visual acuity, and refraction.
Conclusions
Extreme prematurity without impact of ROP is associated with increased GCL + , ONL, and RT thickness at FC as well as reduced FD compared to full-term controls at age 6.5. This indicates that prematurity per se may have a profound effect on foveal anatomical maturation during the first months after birth. Our results suggest RT at FC to be a simple and useful measure of foveal anatomical immaturity.
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25
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He Y, Chen X, Tsui I, Vajzovic L, Sadda SR. Insights into the developing fovea revealed by imaging. Prog Retin Eye Res 2022; 90:101067. [PMID: 35595637 DOI: 10.1016/j.preteyeres.2022.101067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/17/2022]
Abstract
Early development of the fovea has been documented by histological studies over the past few decades. However, structural distortion due to sample processing and the paucity of high-quality post-mortem tissue has limited the effectiveness of this approach. With the continuous progress in high-resolution non-invasive imaging technology, most notably optical coherence tomography (OCT) and OCT angiography (OCT-A), in vivo visualization of the developing retina has become possible. Combining the information from histologic studies with this novel imaging information has provided a more complete and accurate picture of retinal development, and in particular the developing fovea. Advances in neonatal care have increased the survival rate of extremely premature infants. However, with enhanced survival there has been an attendant increase in retinal developmental complications. Several key abnormalities, including a thickening of the inner retina at the foveal center, a shallower foveal pit, a smaller foveal avascular zone, and delayed development of the photoreceptors have been described in preterm infants when compared to full-term infants. Notably these abnormalities, which are consistent with a partial arrest of foveal development, appear to persist into later childhood and adulthood in these eyes of individuals born prematurely. Understanding normal foveal development is vital to interpreting these pathologic findings associated with prematurity. In this review, we first discuss the various advanced imaging technologies that have been adapted for imaging the infant eye. We then review the key events and steps in the development of the normal structure of the fovea and contrast structural features in normal and preterm retina from infancy to childhood. Finally, we discuss the development of the perifoveal retinal microvasculature and highlight future opportunities to expand our understanding of the developing fovea.
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Affiliation(s)
- Ye He
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA; Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, China
| | - Xi Chen
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA
| | - Irena Tsui
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA
| | - Srinivas R Sadda
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA.
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26
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Salari F, Hatami V, Mohebbi M, Ghassemi F. Assessment of relationship between retinal perfusion and retina thickness in healthy children and adolescents. PLoS One 2022; 17:e0273001. [PMID: 35951598 PMCID: PMC9371266 DOI: 10.1371/journal.pone.0273001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/30/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To determine the correlations between inner, mid, and outer retinal thickness (RT) and allied retinal and choroidal vascular densities (VD) at macula in normal healthy children and adolescents. Methods This cross-sectional study included a total of 108 eyes of 59 subjects. Optical coherence tomography angiography (OCTA-Optovue) was used to measure the thickness of the inner-retina (IRT), mid-retina (MRT), and outer-retina (ORT) at foveal (central 1mm), parafoveal (1–3 mm), and perifoveal (3–6 mm) areas, as well as the corresponding VD of the superficial capillary plexus (SVD), deep capillary plexus (DVD), and choricapillaris (CVD). Results The study enrolled 108 normal eyes from 54 participants with a mean age of 10.9 years. Partial correlations showed that the nasal and inferior parafoveal and perifoveal subsegments IRT, MRT and ORT are more affected by all SVD, DVD, and CVD. Nasal parafoveal and perifoveal MRT and all three capillary layers have a constant negative correlation. ORT was not affected by all three layers except for CVD at fovea. The regression analysis revealed that SVD and CVD were significantly associated with foveal and parafoveal and perifoveal IRT. DVD and gender could significantly affect perifoveal IRT. However, only CVD was significantly affected foveal MRT. Based on regression analysis, only CVD was significantly associated with foveal and parafoveal ORT, but not with perifoveal ORT. Conclusion The thickness of different retinal layers correlates with retinal and choroidal VD in different ways according to their zones.
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Affiliation(s)
- Farhad Salari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Hatami
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mohebbi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Cornea Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Ghassemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Retina & Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
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27
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Najeeb S, Ganne P, Damagatla M, Chaitanya G, Krishnappa NC. Mapping the thickness of retinal layers using Spectralis spectral domain optical coherence tomography in Indian eyes. Indian J Ophthalmol 2022; 70:2990-2997. [PMID: 35918959 PMCID: PMC9672761 DOI: 10.4103/ijo.ijo_81_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose: This study aimed at establishing the normative data for the thickness of macular layers on Spectralis Spectral-domain optical coherence tomography (SD-OCT) in healthy Indian eyes and testing the effects of age, gender, central corneal thickness (CCT), and intraocular pressure (IOP) on such values. Methods: This cross-sectional study was done on 308 eyes of 159 healthy subjects. OCT scans were obtained using the posterior pole asymmetry scan protocol. From the thickness map, data were grouped into nine Early Treatment Diabetic Retinopathy Study (ETDRS) macular sectors. Correlation between retinal thickness and age/IOP/CCT was done using Pearson correlation. Correcting for age as a covariate, multivariate regression analysis was done to know which retinal layers showed significant differences in thickness between males and females. Results: The mean age was 46.06 ± 13.06 years (range: 20–75 years). Significant central subfield (CSF) thickening with age was noted in retinal nerve fiber layer (RNFL), inner nuclear layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and outer nuclear layer (ONL) (P < 0.04). The average thickness of the outer ring reduced with age in the ganglion cell layer (GCL)/IPL/INL (P = 0.001). Women had thinner inner and outer retinal thickness than men in all ETDRS rings (P < 0.001). There was no interocular asymmetry (P > 0.05) and no correlation between IOP/CCT and retinal layer thickness. Conclusion: In CSF, age-related thickening was noted in RNFL, IPL, INL, OPL, and ONL. The average inner ring thickness decreased with age in GCL and IPL and increased in the RPE layer. The average outer ring thickness decreased with age in GCL, IPL, and INL layers and increased in OPL. The average IR and OR thickness was significantly less in women compared to men in all sub-fields. There was no correlation between IOP/CCT and retinal layer thickness.
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Affiliation(s)
- Shaista Najeeb
- Department of Ophthalmology, All India Institute of Medical Sciences, Guntur, Andhra Pradesh, India
| | - Pratyusha Ganne
- Department of Ophthalmology, All India Institute of Medical Sciences, Guntur, Andhra Pradesh, India
| | - Manikanta Damagatla
- Department of Ophthalmology, All India Institute of Medical Sciences, Guntur, Andhra Pradesh, India
| | - Ganne Chaitanya
- Department of Neurology, University of Texas Health Science Centre at Houston, TX, United States of America
| | - Nagesha C Krishnappa
- Department of Vitreo-Retina, B W Lions Superspeciality Eye Hospital, Bengaluru, Karnataka, India
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28
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He Y, Pettenkofer M, Chu A, Sadda SR, Corradetti G, Tsui I. Characterization of Foveal Development in Treatment-Naïve Extremely Preterm Infants. Transl Vis Sci Technol 2022; 11:11. [PMID: 35696134 PMCID: PMC9202331 DOI: 10.1167/tvst.11.6.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To characterize and quantify foveal development in treatment-naïve extremely preterm infants using optical coherence tomography. Methods In this cross-sectional study, eyes treated for retinopathy of prematurity before imaging were excluded. Inner retinal thickness and outer retina thickness at foveal center and foveal rim were assessed. Extremely preterm (EPT, <28 weeks gestational age) eyes were compared with infants more than 28 weeks of gestation using a multivariable dimension reduction analysis (principal component analysis) and a bilinear factor mode analysis (partial least square discriminant analysis) to determine group intervariability. Further analyses were performed to investigate the effects of gestation on foveal development. Results Twenty-six infants born at gestational ages ranging from 22 to 39 weeks were imaged between 32 and 80 weeks postmenstrual age. A principal component analysis and partial least squares discriminant analysis revealed that the foveal inner retina thickness was the main difference between EPT infants and non-EPT infants. This difference was reflected by comparing their inner retinal thickness over time (32-80 weeks postmenstrual age), which revealed a sustained thicker foveal inner retina for EPT infants when compared with non-EPT infants. The foveal pit seemed to be shallower in EPT infants when compared with non-EPT infants. Conclusions Twenty-eight weeks of gestation seems to be a critical timepoint for foveal development; EPT infants had altered foveal inner retinal development throughout early postnatal development, which led to a thicker foveal inner retina and a shallower foveal pit soon after birth. Translational Relevance Measuring untreated foveal parameters informs about the effects of prematurity on the fovea and provides a baseline when comparing with post-treatment foveal development.
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Affiliation(s)
- Ye He
- Department of Ophthalmology, Doheny Eye Institute, Stein Eye institute, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA.,Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Moritz Pettenkofer
- Department of Ophthalmology, Doheny Eye Institute, Stein Eye institute, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Alison Chu
- Department of Pediatrics, Division of Neonatology and Developmental Biology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Srinivas R Sadda
- Department of Ophthalmology, Doheny Eye Institute, Stein Eye institute, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Giulia Corradetti
- Department of Ophthalmology, Doheny Eye Institute, Stein Eye institute, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Irena Tsui
- Department of Ophthalmology, Doheny Eye Institute, Stein Eye institute, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
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29
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Thomas MG, Papageorgiou E, Kuht HJ, Gottlob I. Normal and abnormal foveal development. Br J Ophthalmol 2022; 106:593-599. [PMID: 33148537 DOI: 10.1136/bjophthalmol-2020-316348] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 01/06/2023]
Abstract
Normal foveal development begins in utero at midgestation with centrifugal displacement of inner retinal layers (IRLs) from the location of the incipient fovea. The outer retinal changes such as increase in cone cell bodies, cone elongation and packing mainly occur after birth and continue until 13 years of age. The maturity of the fovea can be assessed invivo using optical coherence tomography, which in normal development would show a well-developed foveal pit, extrusion of IRLs, thickened outer nuclear layer and long outer segments. Developmental abnormalities of various degrees can result in foveal hypoplasia (FH). This is a characteristic feature for example in albinism, aniridia, prematurity, foveal hypoplasia with optic nerve decussation defects with or without anterior segment dysgenesis without albinism (FHONDA) and optic nerve hypoplasia. In achromatopsia, there is disruption of the outer retinal layers with atypical FH. Similarly, in retinal dystrophies, there is abnormal lamination of the IRLs sometimes with persistent IRLs. Morphology of FH provides clues to diagnoses, and grading correlates to visual acuity. The outer segment thickness is a surrogate marker for cone density and in foveal hypoplasia this correlates strongly with visual acuity. In preverbal children grading FH can help predict future visual acuity.
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Affiliation(s)
- Mervyn G Thomas
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Eleni Papageorgiou
- Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
| | - Helen J Kuht
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Irene Gottlob
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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30
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Nicholson R, Osborne D, Fairhead L, Beed L, Hill CM, Lee H. Segmentation of the foveal and parafoveal retinal architecture using handheld spectral-domain optical coherence tomography in children with Down syndrome. Eye (Lond) 2022; 36:963-968. [PMID: 35001092 PMCID: PMC9046253 DOI: 10.1038/s41433-021-01883-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/21/2021] [Accepted: 11/29/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Down syndrome is a common multigene, multisystem disorder associated with abnormalities of visual function and characteristic changes in the majority of tissues in the eye. Historic descriptions of macular structure in Down syndrome have been variable, but optical coherence tomography allows increasingly detailed characterization of retinal architecture in vivo. We demonstrate the feasibility of retinal imaging in children with Down syndrome using handheld OCT in an outpatient clinical setting, and describe the foveal and parafoveal retinal architecture in this group. METHODS Fourteen White British children aged between 4 and 11 with Down syndrome were recruited to have handheld SD-OCT retinal imaging performed at a single centre in an outpatient clinical setting. The thickness of the retinal layers at the fovea and parafovea was analysed using segmentation software, and compared with age-matched controls from a previously published normative UK dataset. RESULTS Sixty-seven percent of the children studied had grade 1 foveal hypoplasia. At the fovea, the ganglion cell layer (p = 0.002) and inner nuclear layer (p < 0.001) were thickened relative to the control group. At the parafovea, there was thickening of the retina attributable to numerous layers in both the inner and outer retina, which remained significant after Bonferroni correction. CONCLUSION OCT imaging of children with Down syndrome in an outpatient setting is feasible. There is a high incidence of foveal hypoplasia in this group, associated with thickening of the ganglion cell and inner nuclear layers at the fovea.
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Affiliation(s)
- Rory Nicholson
- grid.430506.40000 0004 0465 4079Department of Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Daniel Osborne
- grid.430506.40000 0004 0465 4079Department of Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK ,grid.5491.90000 0004 1936 9297 School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lisa Fairhead
- grid.5491.90000 0004 1936 9297 School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Leonora Beed
- grid.5491.90000 0004 1936 9297 School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Catherine M. Hill
- grid.5491.90000 0004 1936 9297 School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK ,grid.430506.40000 0004 0465 4079 Department of Sleep Medicine, Southampton Children’s Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Helena Lee
- grid.430506.40000 0004 0465 4079Department of Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK ,grid.5491.90000 0004 1936 9297 School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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31
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Shouchane-Blum K, Gal-Or O, Barayev E, Nemet A, Sternfeld A, Ben Ishai M, Axer-Siegel R, Erhlich R, Friling R. Functional and Structural Findings in Infants Treated for Retinopathy of Prematurity Using Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina 2022; 53:194-201. [PMID: 35417298 DOI: 10.3928/23258160-20220316-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To assess the foveal microvascular structure of children with retinopathy of prematurity (ROP) treated with diode laser photocoagulation using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS OCTA was performed at a tertiary medical center in 17 children (27 eyes) aged 4 to 16 years with a history of diode laser photocoagulation treated ROP. OCTA parameters were compared with those of 12 healthy age-matched controls (23 eyes) attending the orthoptics clinic and correlated with clinical factors. RESULTS Compared with controls, the ROP group had a smaller foveal avascular zone area (P < .001), lower deep vascular plexus density (P < .001), lower flow density (P = .025), and greater central macular thickness (P < .001). High intraventricular hemorrhage grade correlated with smaller foveal avascular zone area (P = .008) and greater inner macular thickness (P = .047). There was no impact of gestational age, birth weight, or refractive status. CONCLUSION OCTA can identify significant quantifiable long-term macular microvascular and structural changes in this patient population. [Ophthalmic Surg Lasers Imaging Retina. 2022;53(4):194-201.].
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Quantitative Optical Coherence Tomography for Longitudinal Monitoring of Postnatal Retinal Development in Developing Mouse Eyes. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12041860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A better study of postnatal retinal development is essential for the in-depth understanding of the nature of the vision system. To date, quantitative analysis of postnatal retinal development is primarily limited to endpoint histological examination. This study is to validate in vivo optical coherence tomography (OCT) for longitudinal monitoring of postnatal retinal development in developing mouse eyes. OCT images of C57BL/6J mice were recorded from postnatal day (P) 14 to P56. Three-dimensional (3D) frame registration and super averaging were adopted to investigate the fine structure of the retina. Quantitative OCT analysis revealed distinct outer and inner retinal layer changes, corresponding to eye development. At the outer retina, external limiting membrane (ELM) and ellipsoid zone (EZ) band intensities gradually increased with aging, and the IZ band was detectable by P28. At the inner retina, a hyporeflective layer (HRL) between the nerve fiber layer (NFL) and inner plexiform layer (IPL) was observed in developing eyes and gradually disappeared with aging. Further image analysis revealed individual RGCs within the HRL layer of the young mouse retina. However, RGCs were merged with the NFL and the IPL in the aged mouse retina. Moreover, the sub-IPL layer structure was observed to be gradually enhanced with aging. To interpret the observed retinal layer kinetics, a model based on eyeball expansion, cell apoptosis, and retinal structural modification was proposed.
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Baraas RC, Pedersen HR, Knoblauch K, Gilson SJ. Human Foveal Cone and RPE Cell Topographies and Their Correspondence With Foveal Shape. Invest Ophthalmol Vis Sci 2022; 63:8. [PMID: 35113142 PMCID: PMC8819292 DOI: 10.1167/iovs.63.2.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose To characterize the association between foveal shape and cone and retinal pigment epithelium (RPE) cell topographies in healthy humans. Methods Multimodal adaptive scanning light ophthalmoscopy and optical coherence tomography (OCT) were used to acquire images of foveal cones, RPE cells, and retinal layers in eyes of 23 healthy participants with normal foveas. Distributions of cone and RPE cell densities were fitted with nonlinear mixed-effects models. A linear mixed-effects model was used to examine the relationship between cone and RPE inter-cell distances and foveal shape as obtained from the OCT scans of retinal thickness. Results The best-fit model to the cone densities was a power function with a nasal–temporal asymmetry. There was a significant linear relationship among cone and RPE cell spacing, foveal shape, and foveal cell topography. The model predictions of the central 10° show that the contributions of both the cones and RPE cells are necessary to account for foveal shape. Conclusions The results indicate that there is a strong relationship between cone and RPE cell spacing and the shape of the human adolescent and adult fovea. This finding adds to the existing evidence of the critical role that the RPE serves in fetal foveal development and through adolescence, possibly via the imposition of constraints on the number and distribution of foveal cones.
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Affiliation(s)
- Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hilde R Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Kenneth Knoblauch
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.,Stem Cell and Brain Research Institute, INSERM U1208, Bron, France.,Université de Lyon, Lyon, France
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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Ayala GD, Linderman RE, Valenzuela RK, Woertz EN, Brilliant M, Tarima S, Carroll J. Assessing Foveal Structure in Individuals with TYR R402Q and S192Y Hypomorphic Alleles. OPHTHALMOLOGY SCIENCE 2021; 1:100077. [PMID: 36246950 PMCID: PMC9560529 DOI: 10.1016/j.xops.2021.100077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 10/31/2022]
Abstract
Purpose Design Participants Methods Main Outcome Measures Results Conclusions
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Casas-Llera P, Ruiz-Casas D, Alió JL. Macular involvement in congenital aniridia. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96 Suppl 1:60-67. [PMID: 34836590 DOI: 10.1016/j.oftale.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/28/2020] [Indexed: 06/13/2023]
Abstract
This review updates the knowledge about the morphological assessment of the foveal hypoplasia in congenital aniridia and resumes the reported genotype-phenotype correlations known to date. Congenital aniridia is a pan ocular disease. Although iris absence is considered the hallmark of this entity, foveal hypoplasia is present in 94.7%-84% of patients. A foveal morphology assessed by optical coherence tomography in which external retina structures can be identified, with presence of the lengthening of photoreceptors outer segment and a greater external retinal thickness, is associated with a better visual outcome, regardless a foveal pit is identified or not. This analysis can be performed once the external retina has completed its differentiation, by 6 years old. PAX6 mutations that introduce premature termination codon, C terminal extension or PAX6 involving deletions have been related to lesser foveal differentiation. Better foveal differentiation has been associated to non-coding PAX6 mutations.
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Affiliation(s)
- P Casas-Llera
- Unidad de Glaucoma, Vissum Mirasierra, Madrid, Spain; Unidad de Glaucoma, Fernández Casas Oftalmólogos, Torrelavega, Cantabria, Spain.
| | - D Ruiz-Casas
- Departamento de Oftalmología, Hospital Ramón y Cajal, Madrid, Spain
| | - J L Alió
- Unidad de Córnea, Cataratas y Cirugía Refractiva de Vissum (Grupo Miranza), Alicante, Spain; Departamento de Oftalmología, Patología y Cirugía, Universidad Miguel Hernández, Alicante, Spain
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36
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Stenkamp DL, Viall DD, Mitchell DM. Evidence of regional specializations in regenerated zebrafish retina. Exp Eye Res 2021; 212:108789. [PMID: 34653519 DOI: 10.1016/j.exer.2021.108789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/08/2021] [Accepted: 10/09/2021] [Indexed: 10/20/2022]
Abstract
Adult zebrafish are capable of functional retinal regeneration following damage. A goal of vision science is to stimulate or permit a similar process in mammals to treat human retinal disease and trauma. Ideally such a process would reconstitute the stereotyped, two-dimensional topographic patterns and regional specializations of specific cell types, functionally important for representation of the visual field. An example in humans is the cone-rich fovea, essential for high-acuity color vision. Stereotyped, global topographic patterns of specific retinal cell types are also found in zebrafish, particularly for cone types expressing the tandemly-replicated lws (long wavelength-sensitive) and rh2 (middle wavelength-sensitive) opsins. Here we examine whether regionally specialized patterns of LWS1 and LWS2 cones are restored in regenerated retinas in zebrafish. Adult transgenic zebrafish carrying fluorescent reporters for lws1 and lws2 were subjected to retinal lesions that destroy all neurons but spare glia, via intraocular injection of the neurotoxin ouabain. Regenerated and contralateral control retinas were mounted whole or sectioned, and imaged. Overall spatial patterns of lws1 vs. lws2 opsin-expressing cones in regenerated retinas were remarkably similar to those of control retinas, with LWS1 cones in ventral/peripheral regions, and LWS2 cones in dorsal/central regions. However, LWS2 cones occupied a smaller fraction of regenerated retina, and several cones co-expressed the lws1 and lws2 reporters in regenerated retinas. Local patterns of regenerated LWS1 cones showed modest reductions in regularity. These results suggest that some of the regional patterning information, or the source of such signals, for LWS cone subtypes may be retained by undamaged cell types (Müller glia or RPE) and re-deployed during regeneration.
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Affiliation(s)
- Deborah L Stenkamp
- Department of Biological Sciences, University of Idaho, Moscow, ID, 82844, USA.
| | - Derek D Viall
- Department of Biological Sciences, University of Idaho, Moscow, ID, 82844, USA
| | - Diana M Mitchell
- Department of Biological Sciences, University of Idaho, Moscow, ID, 82844, USA
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Vohnsen B. Geometrical scaling of the developing eye and photoreceptors and a possible relation to emmetropization and myopia. Vision Res 2021; 189:46-53. [PMID: 34619411 DOI: 10.1016/j.visres.2021.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
In this study the role of vergence in relation to age-dependent scaling of eye and photoreceptor parameters is studied. The underlying hypothesis is that the size and packing of outer segments is matched to the pupil size outdoors in photopic conditions. Vergence is analysed in relation to the angular spectrum of waves being incident using age-dependent data from the literature for the actual geometry and density of photoreceptor cones and rods. This approach is used to derive simple relations for the angular confinement of light along outer segments. Only with a small photopic pupil can leakage and crosstalk for both central and peripheral photoreceptors be entirely ruled out due to the finite length of the outer segments. A limiting 3 mm pupil size is found for children in the school age. Larger pupils will increase the likelihood of leakage and crosstalk that may therefore impact on emmetropization. This study has introduced a new paradigm in myopia research by considering vergence across the 3-D retina as being matched to the angular spectrum of waves being incident from the eye pupil. Emmetropization suggests a delicate balance between photoreceptor outer segment length and density in relation to pupil size. Only when balanced will leakage and crosstalk between adjacent outer segments be effectively suppressed thereby ensuring the highest possible light capture efficiency by visual pigments in the outer segments whether an image is formed on the retina or not.
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Affiliation(s)
- Brian Vohnsen
- Advanced Optical Imaging Group, School of Physics, University College Dublin, Ireland.
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Kilpeläinen M, Putnam NM, Ratnam K, Roorda A. The retinal and perceived locus of fixation in the human visual system. J Vis 2021; 21:9. [PMID: 34643658 PMCID: PMC8525830 DOI: 10.1167/jov.21.11.9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/03/2021] [Indexed: 01/04/2023] Open
Abstract
Due to the dramatic difference in spatial resolution between the central fovea and the surrounding retinal regions, accurate fixation on important objects is critical for humans. It is known that the preferred retinal location (PRL) for fixation of healthy human observers rarely coincides with the retinal location with the highest cone density. It is not currently known, however, whether the PRL is consistent within an observer or is subject to fluctuations and, moreover, whether observers' subjective fixation location coincides with the PRL. We studied whether the PRL changes between days. We used an adaptive optics scanning laser ophthalmoscope to project a Maltese cross fixation target on an observer's retina and continuously imaged the exact retinal location of the target. We found that observers consistently use the same PRL across days, regardless of how much the PRL is displaced from the cone density peak location. We then showed observers small stimuli near the visual field location on which they fixated, and the observers judged whether or not the stimuli appeared in fixation. Observers' precision in this task approached that of fixation itself. Observers based their judgment on both the visual scene coordinates and the retinal location of the stimuli. We conclude that the PRL in a normally functioning visual system is fixed, and observers use it as a reference point in judging stimulus locations.
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Affiliation(s)
- Markku Kilpeläinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Nicole M Putnam
- Arizona College of Optometry, Midwestern University, Glendale, AZ, USA
| | | | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA, USA
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Abstract
Optical coherence tomography (OCT) is widely applied in diagnosis and management of retina diseases particularly macular diseases in adult retina practices. However, it has been under-utilized in pediatric retinal diseases especially in neonates and infants. Utilization of OCT in primary macular diseases in this age group is also uncommon and is less reported. Challenges involved in image acquisition and limitations with available devices technique can explain the limited research and accurate data availability in the literature in this field. Purpose of this review article is to summarize the use of OCT and its importance in various infantile retinal pathologies such as vascular diseases, tumors, retinal dystrophies, and optic nerve pathologies with primary focus on neonates and infants, along with infant choroid. In addition, we also discuss about future directions including OCT angiography for infants.
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Affiliation(s)
- Sushma Jayanna
- Consultant Ophthalmologist, Department of Srimathi Kannuri Santhamma Center of Vitreoretinal Eye Disease, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Subhadra Jalali
- Consultant Ophthalmologist, Department of Srimathi Kannuri Santhamma Center of Vitreoretinal Eye Disease, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Tapas R Padhi
- Consultant Ophthalmologist, Department of Retina and Vitreous, Mithu Tulasi Chanrai Campus, Bhubaneswar, LV Prasad Eye Institute, India
| | - Komal Agarwal
- Consultant Ophthalmologist, Department of Srimathi Kannuri Santhamma Center of Vitreoretinal Eye Disease, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jay Chhablani
- University of Pittsburgh, UPMC Eye Center, Pittsburgh, PA, USA
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40
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Ozen Tunay Z, Idil A. Macular sensitivity assessment and fixation analysis using microperimetry in children with retinopathy of prematurity. Br J Ophthalmol 2021; 106:1767-1771. [PMID: 34108227 DOI: 10.1136/bjophthalmol-2021-319352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/29/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To investigate retinal sensitivity and fixation stability using microperimetry in children with retinopathy of prematurity (ROP). METHODS Observational case series. Totally 51 preterm children who had been followed for ROP were examined in three groups (n=17 in each group). The groups were defined as children without ROP (group 1), children with spontaneously resolved ROP (group 2) and children who had laser treatment for ROP (group 3). All subjects underwent a detailed ophthalmic examination. Macular Analyzer Integrity Assessment Microperimetry was used to analyse macular light sensitivity and fixation stability. The results were compared between groups. The measurements were also analysed according to age, gender, birth weight and gestational age. RESULTS The mean age was 10.84±0.97 years, and 27 children were female. Mean average threshold (AT) for macular sensitivity was 25.5±2.1 decibel in group 1, 26.8±3.8 decibel in group 2 and 26.3±3.0 decibel in group 3. These differences were not statistically significant between the groups (p=0.067), but AT was abnormal in 29% of the whole study population. Outputs about fixation stability were similar between the three groups but fixation was unstable in 27% of the subjects. Mean AT was better in children ≥11 years old compared with the younger ones (p=0.022). CONCLUSION Preterm children may have some abnormalities in macular light sensitivity and fixation stability. These abnormalities may be more prominent in children less than 11 years old. ROP itself or the laser treatment seems not to affect macular light sensitivity and fixation stability.
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Affiliation(s)
- Zuhal Ozen Tunay
- Ophthalmology, University of Health Sciences, Ankara, Turkey .,Ophthalmology, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Aysun Idil
- Ophthalmology Department, Ankara University Faculty of Medicine, Ankara, Turkey
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Agarwal K, Vinekar A, Chandra P, Padhi TR, Nayak S, Jayanna S, Panchal B, Jalali S, Das T. Imaging the pediatric retina: An overview. Indian J Ophthalmol 2021; 69:812-823. [PMID: 33727440 PMCID: PMC8012979 DOI: 10.4103/ijo.ijo_1917_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Recent decade has seen a shift in the causes of childhood blinding diseases from anterior segment to retinal disease in both developed and developing countries. The common retinal disorders are retinopathy of prematurity and vitreoretinal infections in neonates, congenital anomalies in infants, and vascular retinopathies including type 1 diabetes, tumors, and inherited retinal diseases in children (up to 12 years). Retinal imaging helps in diagnosis, management, follow up and prognostication in all these disorders. These imaging modalities include fundus photography, fluorescein angiography, ultrasonography, retinal vascular and structural studies, and electrodiagnosis. Over the decades there has been tremendous advances both in design (compact, multifunctional, tele-consult capable) and technology (wide- and ultra-wide field and noninvasive retinal angiography). These new advances have application in most of the pediatric retinal diseases though at most times the designs of new devices have remained confined to use in adults. Poor patient cooperation and insufficient attention span in children demand careful crafting of the devices. The newer attempts of hand-held retinal diagnostic devices are welcome additions in this direction. While much has been done, there is still much to do in the coming years. One of the compelling and immediate needs is the pediatric version of optical coherence tomography angiography. These needs and demands would increase many folds in future. A sound policy could be the simultaneous development of adult and pediatric version of all ophthalmic diagnostic devices, coupled with capacity building of trained medical personnel.
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Affiliation(s)
- Komal Agarwal
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anand Vinekar
- Department of Pediatric Retina, Narayana Nethralaya Eye Institute, New Delhi, India
| | - Parijat Chandra
- Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Tapas Ranjan Padhi
- Vitreoretina and Uveitis Services, L V Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Odisha, India
| | - Sameera Nayak
- Vitreoretina and Uveitis Services, L V Prasad Eye Institute, Kode Venkatadri Chowdhary Campus, Vijaywada, Andhra Pradesh, India
| | - Sushma Jayanna
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Bhavik Panchal
- Vitreoretina and Uveitis Services, L V Prasad Eye Institute, Granthi Mallikarjun Rao Varalaksmi Campus, Visakhapatnam, Andhra Pradesh, India
| | - Subhadra Jalali
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Taraprasad Das
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Lepore D, Ji MH, Quinn GE, Amorelli GM, Orazi L, Ricci D, Mercuri E. Functional and Morphologic Findings at Four Years After Intravitreal Bevacizumab or Laser for Type 1 ROP. Ophthalmic Surg Lasers Imaging Retina 2021; 51:180-186. [PMID: 32211908 DOI: 10.3928/23258160-20200228-07] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 12/26/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare morphologic and functional status at age 4 years for patients treated in one eye with laser photocoagulation and the other eye with intravitreal bevacizumab (IVB) injection for Type 1 retinopathy of prematurity (ROP). PATIENTS AND METHODS In this single-center, randomized, controlled trial, best-corrected visual acuity (BCVA) in logMAR was obtained along with spherical equivalent refraction (SER), fluorescein angiography (FA), optical coherent tomography (OCT), and OCT angiography (OCTA). RESULTS Eighteen babies (36 eyes) were selected for this study. BCVA and SER were similar in the two groups, but six patients had anisometropia of 4 diopters or more. IVB-treated eyes tended to have thinner foveal thickness than laser-treated eyes (mean difference: -5.33 pixels; 95% confidence interval, -9.62 to -1.05). CONCLUSION Although the differences found here are minimal between the IVB-treated and laser-treated groups, further long-term evaluation of not only FA, but also OCT and OCTA, are needed in larger studies. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:180-186.].
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Evaluating the association of clinical factors and optical coherence tomography retinal imaging with axial length and axial length growth among preterm infants. Graefes Arch Clin Exp Ophthalmol 2021; 259:2661-2669. [PMID: 33779799 DOI: 10.1007/s00417-021-05158-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/05/2021] [Accepted: 03/10/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To study the association of clinical factors and optical coherence tomography (OCT) retinal imaging with axial length (AL) and AL growth in preterm infants METHODS: Among a subgroup of infants from the prospective BabySTEPS study who were screened for retinopathy of prematurity (ROP) and had both AL measured and OCT imaging performed, we analyzed data collected prior to 42 weeks postmenstrual age (PMA) and prior to ROP treatment. Using linear mixed effects models, we evaluated associations between AL and AL growth with gestational age (GA), birthweight, PMA, sex, race, multiparity, maximum ROP stage, and OCT features. RESULTS We included 66 infants (132 eyes), mean GA = 27.6 weeks (SD = 2.3; range: 23.0-34.4) and mean birthweight = 961 g (SD = 269, range: 490-1580). In the final predictive model, longer AL was associated with earlier GA, higher birthweight, later PMA, non-White race, and thicker subfoveal choroid (all p values ≤ 0.01). AL increased linearly up to 42 weeks PMA. There was no difference in AL growth rate by GA, sex, race, multiparity, maximum ROP severity, central foveal thickness, or subfoveal choroidal thickness (all p values > 0.05); but AL growth rate was slower in infants with lower birthweight (p = 0.01). CONCLUSIONS Among preterm infants, those with earlier GA, higher birthweight, later PMA, non-White race, and thicker subfoveal choroid had the longest AL. AL increased linearly up to 42 weeks PMA and lower birthweight was associated with slower AL growth. These findings may improve the accuracy of measurements taken on preterm infants using imaging techniques affected by AL (e.g., measuring lateral dimensions on OCT). TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT02887157 , date of registration: August 25, 2016.
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Nishikawa N, Chua J, Kawaguchi Y, Ro-Mase T, Schmetterer L, Yanagi Y, Yoshida A. Macular Microvasculature and Associated Retinal Layer Thickness in Pediatric Amblyopia: Magnification-Corrected Analyses. Invest Ophthalmol Vis Sci 2021; 62:39. [PMID: 33783486 PMCID: PMC8010361 DOI: 10.1167/iovs.62.3.39] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose The purpose of this study was to characterize macular microvasculature and structural retinal layers using magnification-corrected optical coherence tomography angiography (OCTA) images in children with amblyopia. Methods This prospective cross-sectional study included 22 children with unilateral amblyopia (4–11 years of age) receiving spectral-domain OCTA. Vessel densities in foveal and parafoveal regions of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured in amblyopic and fellow eyes using a customized image analysis program correcting the scale of retinal image with axial length. Iowa Reference Algorithms (Iowa Institute for Biomedical Imaging) were used to measure mean thickness values of 10 intra-retinal layers rescaled for image size correction. Results Foveal and parafoveal vessel densities in amblyopic eyes were lower than that of the fellow eyes in the SCP (fovea: P = 0.006 and parafovea: P = 0.003) and the DCP (P = 0.024 and P = 0.025, respectively). Amblyopic eyes had significantly smaller foveal avascular zone (FAZ) area than fellow eyes (P < 0.001). There were significant differences in retinal layer thickness between paired eyes, particularly in the inner retina in both foveal and parafoveal regions; retinal nerve fiber layer (RNFL) (P = 0.024 and P = 0.095, respectively), ganglion cell layer (P < 0.001 and P = 0.008), inner plexiform layer (IPL; P = 0.12 and P = 0.037), inner nuclear layer (P = 0.005 and P = 0.005), and outer plexiform layer (OPL; P = 0.02 and P = 0.057), except in the foveal IPL, the parafoveal RNFL, and OPL. Conclusions Unilateral amblyopic eyes demonstrate reduced macular vessel density and thicker inner retinal layers compared with fellow eyes even after correcting for image magnification. Changes in macular microvasculature and structural layers may offer valuable insights in the development of amblyopia.
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Affiliation(s)
- Noriko Nishikawa
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
| | - Jacqueline Chua
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore.,Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
| | - Yuriya Kawaguchi
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
| | - Tomoko Ro-Mase
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
| | - Leopold Schmetterer
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore.,Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,Institute for Health Technologies, Nanyang Technological University, Singapore.,Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Yasuo Yanagi
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.,Singapore National Eye Centre, Singapore Eye Research Institute, Singapore.,Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Akitoshi Yoshida
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
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Casas-Llera P, Ruiz-Casas D, Alió JL. Macular involvement in congenital aniridia. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:S0365-6691(21)00007-1. [PMID: 33736873 DOI: 10.1016/j.oftal.2020.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/19/2020] [Accepted: 11/28/2020] [Indexed: 06/12/2023]
Abstract
This review updates the knowledge about the morphological assessment of the foveal hypoplasia in Congenital Aniridia and resumes the reported genotype-phenotype correlations known to date. Congenital Aniridia is a pan ocular disease. Although iris absence is considered the hallmark of this entity, foveal hypoplasia is present in 94.7-84% of patients. A foveal morphology assessed by optical coherence tomography in which external retina structures can be identified, with presence of the lengthening of photoreceptors outer segment and a greater external retinal thickness, is associated with a better visual outcome, regardless a foveal pit is identified or not. This analysis can be performed once the external retina has completed its differentiation, by 6 years old. PAX6 mutations that introduce premature termination codon, C terminal extension or PAX6 involving deletions have been related to lesser foveal differentiation. Better foveal differentiation has been associated to non-coding PAX6 mutations.
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Affiliation(s)
- P Casas-Llera
- Unidad de Glaucoma, Vissum Mirasierra, Madrid, España; Unidad de Glaucoma, Fernández Casas Oftalmólogos, Torrelavega, Cantabria, España.
| | - D Ruiz-Casas
- Departamento de Oftalmología. Hospital Ramón y Cajal, Madrid, España
| | - J L Alió
- Unidad de Córnea, Cataratas y Cirugía Refractiva de Vissum (Grupo Miranza), Alicante, España; Departamento de Oftalmología, Patología y Cirugía, Universidad Miguel Hernández, Alicante, España
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Jabroun MN, AlWattar BK, Fulton AB. Optical Coherence Tomography Angiography in Prematurity. Semin Ophthalmol 2021; 36:264-269. [PMID: 33689582 DOI: 10.1080/08820538.2021.1893760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: During normal foveal development there is a close interaction between the neurosensory and vascular elements of the fovea making it vulnerable to prematurity and retinopathy of prematurity (ROP). We aim to assess this potential effect on foveal development in preterms evaluated simultaneously with both optical coherence tomography (OCT) and OCT angiography (OCTA).Method: Unrestricted literature search in the PubMed and Cochrane library databases yielded 20 distinct citations. Fifteen were relevant and reviewed.Results: In preterms, OCTA demonstrated a significant decrease in the foveal avascular zone area and an increase in foveal vessel density. OCT showed a decrease in foveal pit depth and an increase in the thickness of the subfoveal retinal layers. Some studies correlated these changes with reduced vision.Conclusion: Changes in the vascular and neurosensory retina were found in premature children. It remains unclear whether this is related to prematurity alone or ROP and its treatment.
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Affiliation(s)
- Mireille N Jabroun
- Department of Ophthalmology, Boston Children's Hospital, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Bilal K AlWattar
- Department of Ophthalmology, Boston Children's Hospital, Boston, MA, USA
| | - Anne B Fulton
- Department of Ophthalmology, Boston Children's Hospital, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Optical coherence tomography angiography in preterm-born children with retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 2021; 259:2131-2137. [PMID: 33547964 DOI: 10.1007/s00417-021-05090-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To describe the foveal avascular zone (FAZ) and vessel density (VD) in the superficial and deep capillary plexus in children with a history of prematurity on optical coherence tomography angiography (OCTA) and their correlation with gestational age (GA) and birth weight (BW). METHODS We enrolled 81 preterm- and eight term-born children in this prospective observational study. The Optovue RTVue AVANTI (Optovue Inc., Fremont, CA) was used to procure the OCTA images. The 3 × 3 mm scan protocol centered on the fovea and the central 1 mm of the grid along with the FAZ of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was acquired. RESULTS The mean SCP-VD was comparable between the preterms and term controls (p = 0.315) in the central fovea (1-mm grid). However, the SCP-VD of the 3-mm grid was lower in the preterms born without ROP, with type 1 ROP, and with type 2 ROP (47.61, 47.90, and 48.82 respectively) compared to that in the term group (51.38; p = 0.031). The FAZ in the SCP (p = 0.003) and DCP (p = 0.003) was significantly smaller in the preterms compared to that in the controls. Based on the GA sub-analysis, the FAZ was significantly smaller in the SCP and DCP of preterms born < 31 weeks and > 31 weeks GA (p < 0.000, p < 0.035, respectively). Based on the BW, the difference between the FAZ in the SCP (p = 0.002) and DCP (p = 0.003) was significant. There was no association between the visual acuity and FAZ. CONCLUSION Optical coherence tomography angiography findings in this study show an altered foveal morphology and vascularity in preterms with and without ROP.
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Huang LC, Zhou H, Legocki AT, Scoville NM, Zhong J, Ding L, Wang RK, Cabrera MT. Choroidal Thickness by Handheld Swept-Source Optical Coherence Tomography in Term Newborns. Transl Vis Sci Technol 2021; 10:27. [PMID: 34003912 PMCID: PMC7900868 DOI: 10.1167/tvst.10.2.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To describe normative values for choroidal thickness in newborns and characterize their relationship to vitreoretinal features. Methods Term newborns underwent awake, handheld swept-source optical coherence tomography (SS-OCT) in this prospective cohort study. An automated segmentation algorithm followed by manual adjustments measured choroidal thickness at the fovea and five perifoveal locations. Two masked, trained graders, with a third mediating disagreements, analyzed scans for vitreoretinal findings. OCT vitreoretinal findings, including dome-shaped macula, subretinal fluid, punctate hyperreflective vitreous opacities, persistent inner retinal layers, foveal ellipsoid zone, tractional and non-tractional vitreous bands, epiretinal membrane, cystoid macular edema, vessel elevation, scalloped retinal layers, hyporeflective vessels, and retinal spaces, were assessed and correlated with foveal choroidal thickness using a generalized linear mixed model. Results Fifty-nine eyes of 39 infants (mean gestational age, 39.5 weeks; 18 male, 46%) were included. Mean foveal choroidal thickness was 455.5 ± 93.9 µm. Choroid was thinner inferonasally (343.6 ± 106.2 µm) compared to superonasally (368.4 ± 92.9 µm; P = 0.03) and superotemporally (369.6 ± 100.6 µm; P = 0.02). Thinner foveal choroidal thickness was associated with absence of a foveal ellipsoid zone (437.1 ± 78.5 µm vs. 553.7 ± 93.9 µm; P = 0.02). Choroidal thickness was not significantly associated with other OCT findings. Conclusions We identified an association between thinner choroid and foveal immaturity. Additional study is needed to determine whether choroidal development impacts visual outcomes. Translational Relevance Handheld SS-OCT achieved normative measurements for choroidal thickness across the macula in term newborns, providing a foundation for future investigations into the role of choroidal development in infancy.
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Affiliation(s)
- Laura C Huang
- Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, WA, USA.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Hao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Alex T Legocki
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - N Max Scoville
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Junping Zhong
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Leona Ding
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Ruikang K Wang
- Department of Ophthalmology, University of Washington, Seattle, WA, USA.,Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Michelle T Cabrera
- Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, WA, USA.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
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Maguire AM, Bennett J, Aleman EM, Leroy BP, Aleman TS. Clinical Perspective: Treating RPE65-Associated Retinal Dystrophy. Mol Ther 2021; 29:442-463. [PMID: 33278565 PMCID: PMC7854308 DOI: 10.1016/j.ymthe.2020.11.029] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 12/25/2022] Open
Abstract
Until recently, there was no approved treatment for a retinal degenerative disease. Subretinal injection of a recombinant adeno-associated virus (AAV) delivering the normal copy of the human RPE65 cDNA led to reversal of blindness first in animal models and then in humans. This led to the first US Food and Drug Administration (FDA)-approved gene therapy product for a genetic disease, voretigene neparvovec-rzyl (Luxturna). Luxturna was then approved by the European Medicines Association and is now available in the US through Spark Therapeutics and worldwide through Novartis. Not only has treatment with Luxturna changed the lives of people previously destined to live a life of blindness, but it has fueled interest in developing additional gene therapy reagents targeting numerous other genetic forms of inherited retinal disease. This review describes many of the considerations for administration of Luxturna and describes how lessons from experience with Luxturna could lead to additional gene-based treatments of blindness.
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Affiliation(s)
- Albert M Maguire
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; The Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA
| | - Jean Bennett
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; The Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA
| | - Elena M Aleman
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Bart P Leroy
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Department of Ophthalmology and Center for Medical Genetics Ghent, Ghent University Hospital, Ghent, Belgium
| | - Tomas S Aleman
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; The Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA.
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Macular thickness analysis and resolution of subretinal drusenoid deposits with optical coherence tomography in vitamin A deficiency-related retinopathy. Am J Ophthalmol Case Rep 2021; 21:101023. [PMID: 33644494 PMCID: PMC7887638 DOI: 10.1016/j.ajoc.2021.101023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/23/2020] [Accepted: 01/25/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose To report the resolution of subretinal drusenoid deposits (SDDs) and the changes in macular thickness at various segmentation levels in a patient who was treated for vitamin A deficiency-related retinopathy. Observations A 67-year-old man with cirrhosis secondary to hepatitis C was referred for unexplained vision decline and nyctalopia. He was diagnosed with vitamin A deficiency after he was found to have yellow-white drusen-like deposits in the posterior pole and midperiphery, which corresponded to SDDs on optical coherence tomography (OCT). Treatment with vitamin A supplementation was initiated, and, over the course of eight months, the symptoms improved, the SDDs resolved, and retinal thickness generally increased, although the rate and pattern of change differed depending on the macular quadrant and the segmentation layer being analyzed. Conclusions and importance Vitamin A deficiency should be considered in patients with liver disease who present with drusen-like deposits in the macula and midperiphery. Prompt recognition and treatment may improve symptoms and reverse some retinal pathology, including the presence of SDDs. Vitamin A supplementation in these patients seems to affect the inner retina and outer retina differently.
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