Use of Hand-Held Optical Coherence Tomography during Retinopathy of Prematurity (ROP) Screening demonstrates an increased Outer Retina from early Postmenstrual Age in Preterm Infants with ROP

Abstract

Purpose: To identify structural markers of active retinopathy of prematurity (ROP) in foveal and parafoveal retinal layers using hand-held optical coherence tomography (HH-OCT). Methods: We acquired HH-OCT images (n=278) from a prospective mixed cross-sectional longitudinal observational study of 87 participants (23-36 weeks gestational age (GA); n=30 with ROP, n=57 without ROP) between 31 to 44 weeks postmenstrual age (PMA) excluding treated ROP and features of cystoid macular edema (CME). Six retinal layer thicknesses from the fovea to the parafovea were analysed at five locations up to 1000 µm temporally and nasally. Results: The mean outer retinal thickness (OUTRETL) during active ROP increased at the fovea and parafovea from PMA 33 to 39 weeks ( p <0.001) while the parafoveal inner nuclear layer (INL) and retinal nerve fiber layer (RNFL) reduced ( p <0.001). OUTRETL at the fovea from 33 to 39 weeks PMA was consistently thicker in infants with ROP across all levels of prematurity (GA). Conclusions: Increased foveal and parafoveal outer retina measured using HH-OCT shows potential as a marker for ROP screening.