Outer Retinal Structural Alternation and Segmentation Errors in Optical Coherence Tomography Imaging in Patients With a History of Retinopathy of Prematurity

Abstract

To evaluate retinal anatomy and segmentation errors from spectral-domain optical coherence tomography (SD-OCT) imaging in school-aged children. A prospective cohort study in a referral medical center. One hundred thirty-three eyes of 133 patients were enrolled. Patients were grouped as those who were treated for retinopathy of prematurity (ROP) (ROP-Tx group); those with spontaneously regressed ROP (ROP-non-Tx group); other premature patients (premature group); and full-term age-matched children (full-term group). Anatomy and segmentation errors of retina were evaluated by SD-OCT. The mean age at assessment was 9.5 years (range, 4-16 years). The external limiting membrane (ELM) and the cone outer segment tips (COST) line were least frequently identified in patients of the ROP-Tx group (65.2% and 47.8%, P= .002 and P < .001, respectively). The visual acuity of the patients did not correlate significantly with the absence of COST line (P= .140) but correlated with the absence of ELM (P< .001). The presence of artifacts, including misidentification of the inner retina, misidentification of the outer retina, out-of-register artifacts, off-center scans, and degraded scan images, was observed to range from 0.6% to 50.0% in 4 groups of patients. All types of errors occurred more frequently in the ROP-Tx group than in the full-term group (all P < .05). Outer retinal abnormalities were commonly observed in the ROP-Tx group. The higher segmentation errors in the ROP-Tx group might be related to fine structural abnormalities in the outer retina. Future studies are needed to investigate the mechanisms for these structural changes.