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Najjaran M, Zarei-Ghanavati S, Ostadimoghaddam H, Yekta A, Shoeibi N, Hemmati A, Abrishami M, Akhlaghi S, Ziaei M. Ocular Biometric and Optical Coherence Tomography Parameters in Former Preterm Children: A Cohort Study. J Ophthalmol 2024; 2024:2381582. [PMID: 39376685 PMCID: PMC11458276 DOI: 10.1155/2024/2381582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/31/2024] [Accepted: 09/14/2024] [Indexed: 10/09/2024] Open
Abstract
Purpose To compare biometric and optical coherence tomography parameters as well as refractive status in preterm children aged 4-8 years with or without retinopathy of prematurity (ROP), and evaluate their correlations with age and gender-matched full-term children. Methods Retrospective comparative cohort study of four groups of children. Children with a history of preterm birth, including ROP who received intravitreal bevacizumab (IVB) treatment, children with a history of ROP that regressed without treatment and those with no history of ROP were compared to age and gender-matched full-term children as a control group. Best corrected visual acuity (BCVA), spherical equivalent of refraction (SE), macular and choroidal thickness, as well as biometric parameters was measured. Results A total of 120 eyes of 120 children (30 children in each group) were included. There was no significant difference in BCVA, SE, and subjective cylinder between groups (p=0.05, p=0.3, p=0.6, respectively). Axial length was significantly shorter, and the cornea was steeper in both ROP groups than in other groups (p=0.001, p < 0.001, respectively). The central macular thickness was significantly thicker in the treated, regressed ROP and preterm groups than in full-term children (p < 0.001). The gestational age was negatively correlated with macular thickness in both treated and regressed ROP groups (r = -0.517; p=0.003, r = - 0.490; p=0.006, respectively). Conclusions Children with a history of ROP had a shorter axial length, steeper cornea, and thicker macula that correlated with lower gestational age.
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Affiliation(s)
- Marzieh Najjaran
- Department of OptometrySchool of Paramedical Sciences and RehabilitationMashhad University of Medical Sciences, Mashhad, Iran
- Refractive Errors Research CenterMashhad University of Medical Sciences, Mashhad, Iran
| | - Siamak Zarei-Ghanavati
- Eye Research CenterDepartment of OphthalmologyMashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research CenterMashhad University of Medical Sciences, Mashhad, Iran
| | - Abbasali Yekta
- Department of OptometrySchool of Paramedical Sciences and RehabilitationMashhad University of Medical Sciences, Mashhad, Iran
| | - Nasser Shoeibi
- Eye Research CenterDepartment of OphthalmologyMashhad University of Medical Sciences, Mashhad, Iran
| | - Armin Hemmati
- Eye Research CenterDepartment of OphthalmologyMashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Abrishami
- Eye Research CenterDepartment of OphthalmologyMashhad University of Medical Sciences, Mashhad, Iran
- Ocular Oncology ServiceDepartment of Ophthalmology and Visual SciencesUniversity of Toronto, Toronto, Canada
| | - Saeed Akhlaghi
- Department of BiostatisticsSchool of HealthMashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammed Ziaei
- Department of OphthalmologyNew Zealand National Eye CentreFaculty of Medical and Health SciencesUniversity of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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Czeszyk A, Hautz W, Bulsiewicz D, Jaworski M, Czech-Kowalska J. The long-term influence of perinatal factors on macular morphology and vessel density in preterm children. Early Hum Dev 2024; 192:105993. [PMID: 38643639 DOI: 10.1016/j.earlhumdev.2024.105993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Increased survival rate of extremely preterm children is associated with a higher risk of retinopathy of prematurity (ROP) and long-term sequelae, which implicate retinal changes. PURPOSE To assess an influence of perinatal characteristics on morphology and retinal vascularity of the macula in preterm children. METHODS A cohort of 123 preterm children at the age of 10.5 years (IQR: 8.12-12.77) was prospectively assessed. Optical coherence tomography angiography (OCTA) was performed using RTVueXR Avanti. Foveal thickness, parafoveal thickness, size of foveal avascular zone (FAZ), superficial and deep vessel density, central choroidal thickness (CCT) were analyzed. The associations between OCTA results and perinatal factors, including the presence of ROP and therapy requirements were assessed in preterm children. RESULTS Significantly smaller FAZ, higher foveal thickness and vessel density were noted in children with ROP, Respiratory Distress Syndrome, Bronchopulmonary Dysplasia, required erythropoietin, transfusion or steroids. Foveal thickness was increased in children with ROP (p < 0.001) and following laser treatment (p < 0.05). Thinner CCT was noted in children with a history of sepsis (p < 0.05) and ROP required treatment (p < 0.05). Pregnancy bleeding was associated with higher superficial foveal vessel density (p < 0.05) and smaller FAZ (p < 0.05). CONCLUSION Neonatal factors have a huge impact on retinal development, but the role of prenatal factors should not be neglected in preterm children.
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Affiliation(s)
- Agnieszka Czeszyk
- Department of Ophthalmology, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
| | - Wojciech Hautz
- Department of Ophthalmology, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
| | - Dorota Bulsiewicz
- Department of Neonatology and Neonatal Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
| | - Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
| | - Justyna Czech-Kowalska
- Department of Neonatology and Neonatal Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
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Oruz O, Dervişoğulları MS. Comparison of choroidal structural changes between term and preterm children with and without retinopathy of prematurity. Photodiagnosis Photodyn Ther 2024; 45:103901. [PMID: 37996045 DOI: 10.1016/j.pdpdt.2023.103901] [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: 10/19/2023] [Revised: 11/07/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE To evaluate the effects of prematurity and retinopathy of prematurity (ROP) treatment on choroidal structure using the image binarization method and compare with term children. METHODS Children aged 6-11 years were included in this prospective case-control study. There were 36 (72 eyes) term children and 52 (103 eyes) preterm children included in the study. Subfoveal choroidal thickness (SFCT) and choroidal thickness (CT) at 500, 1500, and 2500 μm temporal and nasal from the fovea were measured. Images were binarized using the Image J program. The choroidal vascularity index (CVI) was calculated by dividing the luminal area by the total subfoveal choroidal area. RESULTS There was no significant difference in SCFT between children born at term (290.44±57.617 μm) and preterm (288±69.270 μm) (p = 0.800). CVI was found to be significantly higher in term children (71.90±2.60 %) than in preterm children (69.58±2.72 %) (p<0.001), and the difference was also significant when compared to preterm children without ROP (p = 0.033). In the preterm subgroups, although CVI was higher in preterm children without ROP (70.42±2.24 %) than in those with spontaneous regression (69.34±3.30 %) and those treated with laser photocoagulation (68.91±2.35 %), there was no significant difference (p = 0.330, p = 0.089 respectively). CVI was similar between children with spontaneous regression and those treated with laser photocoagulation (p = 0.909). CVI and logMAR best corrected visual acuity (BCVA) were inversely correlated (r=-0.295 p<0.001). CONCLUSION Reduced CVI in preterm children indicates that prematurity is related to the choroid. Choroidal vascularity index appears to be a more reliable marker than CT for evaluating the relationship between choroid and ROP.
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Affiliation(s)
- Oğuzhan Oruz
- Department of Ophthalmology, Başkent University School of Medicine, Adana, Turkey.
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Bahar MM, Salari F, Dastjanifarahani A, Ghassemi F, Harper CA, Bazvand F. Choroidal measurements in decision making for retinopathy of prematurity: a decision tree analysis. Int J Retina Vitreous 2024; 10:4. [PMID: 38212793 PMCID: PMC10782690 DOI: 10.1186/s40942-023-00520-6] [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: 10/20/2023] [Accepted: 12/16/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND To compare the choroidal thickness and vascular profile of premature infants with ROP (retinopathy of prematurity) using a handheld SD-OCT device. METHODS We performed horizontal SD-OCT scans through the fovea in 115 eyes of 66 premature infants. Premature infants included 2 groups [infants with ROP requiring treatment (as treatment group) vs. infants without ROP or with ROP not- requiring treatment (as no-treatment group)] Choroidal thicknesses (CT) were measured at 5 points, including the fovea, 250 µm, and 500 µm mm nasal and temporal to the fovea. The choroidal vascularity index (CVI) and choroidal stromal index (CSI) were also calculated. The classification and regression tree (CRT) algorithm was used to predict the need for treatment based on all OCT characteristics. RESULTS Mean CT was higher in 500 µm nasal to the fovea compared to temporal CT (275.8 ± 64.8 and 257.1 ± 57.07, P value < 0.03). No statistically significant difference was found regarding CVI, corrected CVI, and temporal and nasal CT in the treatment group versus the no-treatment group. The foveal CT was significantly lower in ROP patients with the plus disease compared to not-plus ROP (P value = 0.03. ANOVA, Bonferroni posthoc test). CT was not significantly different between plus and pre-plus patients (P-value = 0.9, ANOVA, Bonferroni posthoc test). No significant relationship was found between the stage of ROP and choroidal thickness (P value > 0.05, GEE). The decision tree analysis showed that in infants with ROP, the most important predictor for the need for treatment is CSI. CONCLUSION This study delineated the possible effectiveness of choroidal measurements as an additive to decision-making for ROP. We also demonstrated that choroidal involution is associated with the presence of plus disease, not with the stage of ROP. We demonstrated that choroidal measurements are very sensitive but not specific tools for assessing the need for treatment in ROP patients.
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Affiliation(s)
- Mohammadreza Mehrabi Bahar
- Retina Services, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar Street, Tehran, Iran
| | - Farhad Salari
- Retina Services, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar Street, Tehran, Iran
| | - Afsar Dastjanifarahani
- Retina Services, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar Street, Tehran, Iran
| | - Fariba Ghassemi
- Retina Services, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar Street, Tehran, Iran
| | - C Armitage Harper
- Austin Retina Associates, University of Texas-San Antonio, Austin, USA
| | - Fatemeh Bazvand
- Retina Services, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar Street, Tehran, Iran.
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Kizilay O, Akarsu Acar OP. Swept-Source Optical Coherence Tomography in Preschool Children with a History of Treated or Spontaneously Regressed Retinopathy of Prematurity. Semin Ophthalmol 2022; 37:780-785. [PMID: 35834678 DOI: 10.1080/08820538.2022.2100713] [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: 10/17/2022]
Abstract
PURPOSE To evaluate the best-corrected visual acuity (BCVA), the spherical equivalent (SE), and the central, parafoveal, and perifoveal macular thickness results of the children with a history of treated or spontaneously regressed retinopathy of prematurity (ROP). METHODS Seventy-nine right eyes of 79 children at the age of 5 years old were included in this cross-sectional observational study. Twenty-four infants who received intravitreal bevacizumab (IVB) were in group 1, 27 infants who underwent laser photocoagulation (LPC) were in group 2, and 28 infants who had spontaneous regression were in group 3. Central foveal thickness (CFT) and the thicknesses of four parafoveal and four perifoveal quadrants as superior, temporal, inferior, and nasal were analyzed by using swept-source optical coherence tomography (SS-OCT). RESULTS BCVA was significantly better (p = .002), and the SE was significantly higher in group 3 than in both groups 1 and 2 (p = .033). CFT was significantly lower in group 3 than in both groups 1 and 2 (p < .001). The parafoveal average, temporal, inferior, and nasal thickness values and the perifoveal average, superior, and temporal thickness results were significantly higher in group 2 than in both groups 1 and 3 (p = .003, p = .002, p = .009, and p = .009, respectively) (p = .003, p < .001, and p = .007, respectively). CONCLUSION CFT was significantly higher in infants who had treatment for ROP. Parafoveal and perifoveal retinal thicknesses in certain quadrants were higher in those receiving LPC treatment than in others. CFT was negatively correlated with both gestational age and birth weight. Myopia was seen more often in children who had treatment.
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Affiliation(s)
- Osman Kizilay
- Department of Ophthalmology, Istanbul Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Ozge Pinar Akarsu Acar
- Department of Ophthalmology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
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Tan W, Li B, Wang Z, Zou J, Jia Y, Yoshida S, Zhou Y. Novel Potential Biomarkers for Retinopathy of Prematurity. Front Med (Lausanne) 2022; 9:840030. [PMID: 35187013 PMCID: PMC8848752 DOI: 10.3389/fmed.2022.840030] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/12/2022] [Indexed: 12/11/2022] Open
Abstract
Retinopathy of prematurity (ROP) is the main risk factor for vision-threatening disease in premature infants with low birth weight. An accumulating number of independent studies have focused on ROP pathogenesis and have demonstrated that laser photocoagulation therapy and/or anti-VEGF treatment are effective. However, early diagnosis of ROP is still critical. At present, the main method of ROP screening is based on binocular indirect ophthalmoscopy. However, the judgment of whether ROP occurs and whether treatment is necessary depends largely on ophthalmologists with a great deal of experience. Therefore, it is essential to develop a simple, accurate and effective diagnostic method. This review describes recent findings on novel biomarkers for the prediction, diagnosis and prognosis of ROP patients. The novel biomarkers were separated into the following categories: metabolites, cytokines and growth factors, non-coding RNAs, iconography, gut microbiota, oxidative stress biomarkers, and others. Biomarkers with high sensitivity and specificity are urgently needed for the clinical applications of ROP. In addition, using non-invasive or minimally invasive methods to obtain samples is also important. Our review provides an overview of potential biomarkers of ROP.
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Affiliation(s)
- Wei Tan
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Bingyan Li
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Zicong Wang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Jingling Zou
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Yang Jia
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan
| | - Yedi Zhou
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
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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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Choroidal vessel density in unilateral hyperopic amblyopia using en-face optical coherence tomography. BMC Ophthalmol 2020; 20:472. [PMID: 33267849 PMCID: PMC7709249 DOI: 10.1186/s12886-020-01735-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background Structural changes of the choroid, such as choroidal thickening, have been indicated in amblyopic eyes with hyperopic anisometropia as compared to fellow or healthy eyes. The purpose of the present study was to investigate choroidal vascular density (CVD) in children with unilateral hyperopic amblyopia. Methods This study included 88 eyes of 44 patients with unilateral amblyopia due to hyperopic anisometropia with or without strabismus and 29 eyes of 29 age-matched normal controls. The CVD of Haller’s layer was quantified from en-face images constructed by 3-dimensional swept-source optical coherence tomography images flattened relative to Bruch’s membrane. The analysis area was a 3 × 3-mm square of macula after magnification correction. Relationships between CVD and other parameters [best-corrected visual acuity (BCVA), refractive error and subfoveal choroidal thickness (SFCT)] were investigated, and CVDs were compared between amblyopic, fellow, and normal control eyes. Results Mean CVD was 59.11 ± 0.66% in amblyopic eyes, 59.23 ± 0.81% in fellow eyes, and 59.29 ± 0.74% in normal control eyes. CVD showed a significant positive relationship with SFCT (p = 0.004), but no relationships with other parameters. No significant differences in CVD were evident among amblyopic, fellow, and normal control eyes after adjusting for SFCT (p = 0.502). Conclusions CVD was unrelated to BCVA, and CVD did not differ significantly among amblyopic, fellow and normal control eyes. These results suggest that the local CVD of Haller’s layer is unaffected in unilateral hyperopic amblyopic eyes.
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