Analysis of plus disease using handheld spectral-domain optical coherence tomography in nonsedated neonates

Abstract

IntroductionSpectral Domain Optical Coherence Tomography (SDOCT) has only recently been explored in neonates with retinopathy of prematurity (ROP). Vessel architecture has not been studied. This study provides an SDOCT analysis of vascular features in plus disease in nonsedated neonates.MethodsAnalysis was of SDOCT images from 94 neonates (30-52 weeks postmenstrual age) undergoing ROP screening. Ophthalmoscopic findings were obtained from study case report forms. Fourteen neonates with plus disease were compared to 14 randomly-selected neonates without plus disease and with ROP stage 0-2. One eye with the best SDOCT scan quality was graded (masked) from each subject to identify elevated vessels, scalloped retinal layers, hypointense vessels and retinal spaces. A pediatric ophthalmologist evaluated the retinal images generated from SDOCT scans for abnormal dilation and tortuosity.ResultsOf 14 eyes with plus disease, SDOCT scans showed elevated vessels in 10 (71%), scalloped retinal layers in 8 (57%), hypointense vessels in 5 (35%) and retinal spaces in 2 (14%). None of these features were detected in the control group. Retinal images had a limited field of view (1-2 retinal quadrants in 19/28 images, 3 quadrants in 5/28 and 4 quadrants in 4/28). The dilation and tortuosity on retinal images, correlated with clinical judgment in 25/28 eyes.DiscussionSDOCT may potentially aid in future analysis of vascular changes signaling plus disease. Findings from this early feasibility pilot study need to be tested in a larger-scale investigation.ConclusionsSDOCT may complement clinical information in the monitoring of disease progression in neonates with ROP. IntroductionSpectral Domain Optical Coherence Tomography (SDOCT) has only recently been explored in neonates with retinopathy of prematurity (ROP). Vessel architecture has not been studied. This study provides an SDOCT analysis of vascular features in plus disease in nonsedated neonates. Spectral Domain Optical Coherence Tomography (SDOCT) has only recently been explored in neonates with retinopathy of prematurity (ROP). Vessel architecture has not been studied. This study provides an SDOCT analysis of vascular features in plus disease in nonsedated neonates. MethodsAnalysis was of SDOCT images from 94 neonates (30-52 weeks postmenstrual age) undergoing ROP screening. Ophthalmoscopic findings were obtained from study case report forms. Fourteen neonates with plus disease were compared to 14 randomly-selected neonates without plus disease and with ROP stage 0-2. One eye with the best SDOCT scan quality was graded (masked) from each subject to identify elevated vessels, scalloped retinal layers, hypointense vessels and retinal spaces. A pediatric ophthalmologist evaluated the retinal images generated from SDOCT scans for abnormal dilation and tortuosity. Analysis was of SDOCT images from 94 neonates (30-52 weeks postmenstrual age) undergoing ROP screening. Ophthalmoscopic findings were obtained from study case report forms. Fourteen neonates with plus disease were compared to 14 randomly-selected neonates without plus disease and with ROP stage 0-2. One eye with the best SDOCT scan quality was graded (masked) from each subject to identify elevated vessels, scalloped retinal layers, hypointense vessels and retinal spaces. A pediatric ophthalmologist evaluated the retinal images generated from SDOCT scans for abnormal dilation and tortuosity. ResultsOf 14 eyes with plus disease, SDOCT scans showed elevated vessels in 10 (71%), scalloped retinal layers in 8 (57%), hypointense vessels in 5 (35%) and retinal spaces in 2 (14%). None of these features were detected in the control group. Retinal images had a limited field of view (1-2 retinal quadrants in 19/28 images, 3 quadrants in 5/28 and 4 quadrants in 4/28). The dilation and tortuosity on retinal images, correlated with clinical judgment in 25/28 eyes. Of 14 eyes with plus disease, SDOCT scans showed elevated vessels in 10 (71%), scalloped retinal layers in 8 (57%), hypointense vessels in 5 (35%) and retinal spaces in 2 (14%). None of these features were detected in the control group. Retinal images had a limited field of view (1-2 retinal quadrants in 19/28 images, 3 quadrants in 5/28 and 4 quadrants in 4/28). The dilation and tortuosity on retinal images, correlated with clinical judgment in 25/28 eyes. DiscussionSDOCT may potentially aid in future analysis of vascular changes signaling plus disease. Findings from this early feasibility pilot study need to be tested in a larger-scale investigation. SDOCT may potentially aid in future analysis of vascular changes signaling plus disease. Findings from this early feasibility pilot study need to be tested in a larger-scale investigation. ConclusionsSDOCT may complement clinical information in the monitoring of disease progression in neonates with ROP. SDOCT may complement clinical information in the monitoring of disease progression in neonates with ROP.