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VISUAL FUNCTION AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES IN CHILDREN BORN PRETERM

Balasubramanian, Siva, MD, PhD*,†; Borrelli, Enrico, MD*,†,‡; Lonngi, Marcela, MD†,§; Velez, Federico, MD†,§; Sarraf, David, MD†,§,**; Sadda, SriniVas R., MD*,†; Tsui, Irena, MD*,†,§,**

doi: 10.1097/IAE.0000000000002301
Original Study: PDF Only

Purpose: Preterm children have an increased risk of impaired vision from retinopathy, strabismus, and high refractive error. The aim of this study was to investigate the relationship between foveal parameters generated by optical coherence tomography angiography and visual function in preterm children.

Methods: Eighty eyes (32 eyes of former preterm infants and 48 age-matched full-term control eyes) were analyzed. Subjects underwent complete eye examinations including best-corrected visual acuity and retinal imaging with the Optovue XR Avanti optical coherence tomography angiography device. Foveal morphologic parameters including foveal depth, central foveal thickness, inner retinal area, and outer retinal area were measured on a central horizontal B-scan. Foveal vasculature parameters including foveal avascular zone, superficial capillary plexus-vessel density, and deep capillary plexus-vessel density were measured on optical coherence tomography angiography.

Results: The best-corrected visual acuity was significantly affected in preterm children compared with controls (P < 0.0001). The central foveal thickness (P < 0.0001), inner retinal area (P = 0.01), and outer retinal area (P = 0.03) were significantly increased in preterm compared with control eyes. Foveal depth (P < 0.001) and foveal avascular zone (P < 0.001) were significantly decreased in preterm compared with control eyes. The superficial capillary plexus-vessel density (P = 0.01) and deep capillary plexus-vessel density (P = 0.003) at the fovea (1 mm) were significantly increased in preterm compared with control eyes. The best-corrected visual acuity was negatively correlated with foveal depth (r = −0.42, P = 0.001) and foveal avascular zone (r = −0.53, P < 0.001), and positively correlated with central foveal thickness (r = 0.32, P = 0.01) and inner retinal area (r = 0.32, P = 0.01), indicating that worse visual acuity was associated with a smaller foveal avascular zone, shallower foveal depth, increased central foveal thickness, and larger inner retinal area.

Conclusion: Foveal morphology and vasculature changes in preterm children were associated with impaired visual function. Further longitudinal studies are required to evaluate these changes over time.

Preterm children have an increased risk of impaired vision. The foveal morphologic and vasculature changes investigated by optical coherence tomography angiography were associated with impaired visual function in preterm children.

*Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California;

Retina Division, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California;

Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. D'Annunzio Chieti-Pescara, Chieti, Italy;

§Stein Eye Institute, University of California Los Angeles, Los Angeles, California;

and **Greater Los Angeles VA Healthcare Center, Los Angeles, California.

Reprint requests: Irena Tsui, MD, Retina Division, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095; e-mail: ITsui@jsei.ucla.edu

This work was completed at the Department of Ophthalmology at UCLA supported by an Unrestricted Grant from Research to Prevent Blindness, Inc, to the Department of Ophthalmology at UCLA.

F. Velez receives funding support from Retrophin, Baush&Lomb, Omeros, and Research to Prevent Blindness. D. Sarraf receives funding support from Allergan, Genentech, Heidelberg, Regeneron, and Optovue and he is a consultant for Amgen, Bayer, Genentech, Heidelberg, Regeneron, Nuvelution, Novartis, and Optovue. S.R. Sadda receives funding support from Allergan, Carl Zeiss Meditec, Genentech, Optos, Optovue, and Regeneron and he is a consultant for Allergan, Genentech, Iconic, Novartis, Optos, Optovue, Regeneron, Thrombogenics, CenterVue, and Heidelberg. The remaining authors have no conflicts of interest to disclose.

© 2018 by Ophthalmic Communications Society, Inc.