Choroidal Thickness with Swept-Source Optical Coherence Tomography versus Foveal Morphology in Young Children with a History of Prematurity.

AIM: Comparison of choroidal thickness (CT) and foveal morphology as seen with swept-source optical coherence tomography (SS-OCT) in children with a history of treated or spontaneously regressed retinopathy of prematurity (tROP or srROP) to assess the impact on best-corrected visual acuity (BCVA). METHODS: CT was measured by SS-OCT (DRI-OCT Triton; Topcon, USA) single scans of a 6-mm diameter around the fovea in 17 children with tROP or srROP (4-7 years of age) and compared to 25 controls (age-matched children and adults). The disproportion of the outer nuclear layer and inner retinal layers at the fovea (i.e., the ONL+/IRL ratio) as a measure of macular developmental arrest (MDA) was manually analyzed. BCVA was tested with ETDRS letter charts and correlated with the morphology. RESULTS: CT was significantly thinner in children with tROP and srROP compared to term-born healthy children (nKids) at all measurement marks (p < 0.001), and mostly affected in the subfoveal area. tROP showed the lowest CT. CT allowed no direct conclusion about ONL+/IRL, but correlated positively with BCVA. CONCLUSIONS: Reduced CT in children with a history of ROP is linked to ROP severity. These findings overlap with the degree of MDA. CT appears to be involved in ROP, but MDA showed a higher impact on the BCVA of the examined cohort.

OCT Angiography in Young Children with a History of Retinopathy of Prematurity.

PURPOSE: To describe the size and appearance of the foveal avascular zone (FAZ) in the superficial and deep plexus in young children with treated or spontaneously regressed retinopathy of prematurity (ROP), in comparison with age-matched controls and young adults, as seen with OCT angiography (OCTA), and to compare these parameters with foveal classic OCT images and visual function. DESIGN: Prospective, cross-sectional study. PARTICIPANTS: Twenty-five children with treated or spontaneously regressed ROP (mean 5.0±0.8 years) compared with 15 healthy term-born age-matched children and 20 healthy adults. METHODS: OCTA was performed using a DRI OCT Triton (Swept Source OCT, Topcon, Oakland, NJ). The best-quality images of 1 eye per patient were analyzed. Superficial FAZ and deep FAZ were analyzed separately. Single-scan OCTs were performed using a Spectralis SD-OCT (HRA+OCT, Heidelberg Engineering, Heidelberg, Germany). The foveal pit characteristics and the degree of macular developmental arrest (MDA), defined as the ratio of the outer nuclear layer + external limiting membrane (ONL+) and the inner retinal layers in the fovea (ONL+/IRL-ratio), were analyzed with a custom-made automated layer segmentation tool (DiOCTA, copyright by Justus-Liebig-University, Giessen, Germany). Visual acuity (VA) was tested with Early Treatment of Diabetic Retinopathy Study letter charts. MAIN OUTCOME MEASURES: The ONL+/IRL-ratio, superficial FAZ area, deep FAZ area, foveal parameters, and VA. RESULTS: Foveal pit depth and area were significantly reduced in both treated and spontaneously regressed ROP, whereas the foveal diameter was comparable in all groups. OCTA showed a significantly narrowed superficial FAZ in eyes with treated and spontaneously regressed ROP. In contrast, the deep FAZ was of comparable size in all groups. A reduced superficial FAZ significantly correlated with reduced ONL+/IRL-ratio, and thus the degree of MDA. In treated and spontaneously regressed ROP, reduced superficial FAZ and MDA correlated significantly with diminished VA. CONCLUSIONS: OCTA is feasible in young children with a history of ROP and without neurodevelopmental delay. It allows detecting a decreased superficial FAZ size noninvasively. A small superficial FAZ, reduced ONL+/IRL-ratio as a measure of MDA, and reduced VA are concurrent factors in preterm children who are otherwise neurologically normal.