Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography
Background: Retinal morphology changes may be associated with prematurity and can lead to visual impairment. Optical coherence tomography angiography may contribute to understanding the pathomechanism of structural and vascular retinal impairment in premature children. The aim of this study was to a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/5/1337 |
| _version_ | 1797474692820369408 |
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| author | Agnieszka Czeszyk Wojciech Hautz Maciej Jaworski Dorota Bulsiewicz Justyna Czech-Kowalska |
| author_facet | Agnieszka Czeszyk Wojciech Hautz Maciej Jaworski Dorota Bulsiewicz Justyna Czech-Kowalska |
| author_sort | Agnieszka Czeszyk |
| collection | DOAJ |
| description | Background: Retinal morphology changes may be associated with prematurity and can lead to visual impairment. Optical coherence tomography angiography may contribute to understanding the pathomechanism of structural and vascular retinal impairment in premature children. The aim of this study was to assess an influence of prematurity, neonatal clinical characteristics, and a history of retinopathy of prematurity (ROP) on the morphology and retinal vascularity of macula in children. Methods: A case–control study of 123 preterm children and 86 full-term children was performed. The age of the subjects was 10.45 years (IQR: 8.12–12.77), while the age of the control group was 11.78 years (IQR: 8.81–13.79). Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA, angio-OCT) were performed using RTVueXR Avanti (Optovue, Fremont, CA, USA). Ganglion cell complex (GCC), foveal thickness (FT), parafoveal thickness (PFT), size of foveal avascular zone (FAZ) in superficial plexus, superficial capillary vessel density (sVD), deep capillary vessel density (dVD), central choroidal thickness (CCT), and presence of macular hypoplasia were analyzed. The association between OCT/angio-OCT results and clinical characteristics including the degree of ROP and therapy requirements was assessed in preterm infants. Results: Foveal morphology was affected in preterm children with high incidence of foveal hypoplasia (24.77%). GCC was thinner in preterm children compared to controls: avgGG 93 μm vs. 100 μm, <i>p</i> < 0.001. No associations between GCC and gestational age (<i>R</i> = −0.085; <i>p</i> = 0.228) and birth weight (<i>R</i> = −0.054; <i>p</i> = 0.446) were found. FAZ in preterm group was smaller than in controls (0.13 ± 0.09 vs. 0.22 ± 0.09; <i>p</i> < 0.001). FAZ area correlated with gestational age (<i>R</i> = 0.456; <i>p</i> < 0.001) and birth weight (<i>R</i> = 0.472; <i>p</i> < 0.001). Deep vessel density in the fovea was higher in preterm children than in control group (<i>p</i> < 0.001). PFT was significantly lower in preterm children compared to control group. However, increased thickness in the fovea was noted in preterm children (<i>p</i> < 0.001). FT was inversely correlated with gestational age (<i>R</i> = −0.562; <i>p</i> < 0.001) and birth weight (<i>R</i> = −0.508, <i>p</i> < 0.001). CCT was lower in preterm children (312 μm vs. 337.5 μm, <i>p</i> < 0.001) Parameters of GCC and FT were higher in patients with ROP required treatment compared to patients without ROP and spontaneously regressed retinopathy. FAZ was smaller in patients with retinopathy than in preterm children without ROP. Conclusion: Prematurity has a significant negative impact on GCC, macular morphology, and vascularization. In premature children, decreased FAZ, increased FT, and vessel density were strongly associated with gestational age, birth weight, Apgar score, ROP stage, and treatment requirement. Optical coherence tomography angiography is a useful tool for detecting retinal changes in premature children. |
| first_indexed | 2024-03-09T20:34:45Z |
| format | Article |
| id | doaj.art-2d365f1d33e94b3d96e2aae90f476777 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T20:34:45Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2d365f1d33e94b3d96e2aae90f4767772023-11-23T23:14:20ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-01115133710.3390/jcm11051337Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography AngiographyAgnieszka Czeszyk0Wojciech Hautz1Maciej Jaworski2Dorota Bulsiewicz3Justyna Czech-Kowalska4Department of Ophthalmology, Children’s Memorial Health Institute, 04-730 Warsaw, PolandDepartment of Ophthalmology, Children’s Memorial Health Institute, 04-730 Warsaw, PolandDepartment of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, 04-730 Warsaw, PolandDepartment of Neonatology and Neonatal Intensive Care, Children’s Memorial Health Institute, 04-730 Warsaw, PolandDepartment of Neonatology and Neonatal Intensive Care, Children’s Memorial Health Institute, 04-730 Warsaw, PolandBackground: Retinal morphology changes may be associated with prematurity and can lead to visual impairment. Optical coherence tomography angiography may contribute to understanding the pathomechanism of structural and vascular retinal impairment in premature children. The aim of this study was to assess an influence of prematurity, neonatal clinical characteristics, and a history of retinopathy of prematurity (ROP) on the morphology and retinal vascularity of macula in children. Methods: A case–control study of 123 preterm children and 86 full-term children was performed. The age of the subjects was 10.45 years (IQR: 8.12–12.77), while the age of the control group was 11.78 years (IQR: 8.81–13.79). Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA, angio-OCT) were performed using RTVueXR Avanti (Optovue, Fremont, CA, USA). Ganglion cell complex (GCC), foveal thickness (FT), parafoveal thickness (PFT), size of foveal avascular zone (FAZ) in superficial plexus, superficial capillary vessel density (sVD), deep capillary vessel density (dVD), central choroidal thickness (CCT), and presence of macular hypoplasia were analyzed. The association between OCT/angio-OCT results and clinical characteristics including the degree of ROP and therapy requirements was assessed in preterm infants. Results: Foveal morphology was affected in preterm children with high incidence of foveal hypoplasia (24.77%). GCC was thinner in preterm children compared to controls: avgGG 93 μm vs. 100 μm, <i>p</i> < 0.001. No associations between GCC and gestational age (<i>R</i> = −0.085; <i>p</i> = 0.228) and birth weight (<i>R</i> = −0.054; <i>p</i> = 0.446) were found. FAZ in preterm group was smaller than in controls (0.13 ± 0.09 vs. 0.22 ± 0.09; <i>p</i> < 0.001). FAZ area correlated with gestational age (<i>R</i> = 0.456; <i>p</i> < 0.001) and birth weight (<i>R</i> = 0.472; <i>p</i> < 0.001). Deep vessel density in the fovea was higher in preterm children than in control group (<i>p</i> < 0.001). PFT was significantly lower in preterm children compared to control group. However, increased thickness in the fovea was noted in preterm children (<i>p</i> < 0.001). FT was inversely correlated with gestational age (<i>R</i> = −0.562; <i>p</i> < 0.001) and birth weight (<i>R</i> = −0.508, <i>p</i> < 0.001). CCT was lower in preterm children (312 μm vs. 337.5 μm, <i>p</i> < 0.001) Parameters of GCC and FT were higher in patients with ROP required treatment compared to patients without ROP and spontaneously regressed retinopathy. FAZ was smaller in patients with retinopathy than in preterm children without ROP. Conclusion: Prematurity has a significant negative impact on GCC, macular morphology, and vascularization. In premature children, decreased FAZ, increased FT, and vessel density were strongly associated with gestational age, birth weight, Apgar score, ROP stage, and treatment requirement. Optical coherence tomography angiography is a useful tool for detecting retinal changes in premature children.https://www.mdpi.com/2077-0383/11/5/1337retinopathy of prematurityoptical coherence tomography angiographyretinal vessel densityfoveal avascular zonefoveal hypoplasiaganglion cell complex |
| spellingShingle | Agnieszka Czeszyk Wojciech Hautz Maciej Jaworski Dorota Bulsiewicz Justyna Czech-Kowalska Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography Journal of Clinical Medicine retinopathy of prematurity optical coherence tomography angiography retinal vessel density foveal avascular zone foveal hypoplasia ganglion cell complex |
| title | Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography |
| title_full | Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography |
| title_fullStr | Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography |
| title_full_unstemmed | Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography |
| title_short | Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography |
| title_sort | morphology and vessel density of the macula in preterm children using optical coherence tomography angiography |
| topic | retinopathy of prematurity optical coherence tomography angiography retinal vessel density foveal avascular zone foveal hypoplasia ganglion cell complex |
| url | https://www.mdpi.com/2077-0383/11/5/1337 |
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