New macular changes in acute, mild Retinopathy of prematurity (ROP) evaluated on a Spectral Domain OCT using a modified hand-held device in Asian Indian infants.

Anand Vinekar
Sivakumar Munusamy
Kavitha Avadhani
Padmamalini Mahendradas
Sherine Braganza
Bhujang Shetty

Department of Pediatric Retina, Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India

Purpose: To report macular changes in acute, mild Retinopathy of Prematurity (ROP) using a modified Hand-Held Spectral Domain Optical Coherence Tomography (HH-SDOCT)

Method: The Spectralis (Heidelberg, Germany) was modified to function as a hand held device. Infants with acute ROP of stage 1 and 2 underwent SD-OCT imaging in the outpatient- supine and un-anesthetized, by a method previously published by our group. Normal age matched premature infants acted as controls.

Results: Twenty-seven eyes with stage 1, 79 with stage 2 ROP and 40 normal eyes (controls) underwent serial SD-OCT on the Spectralis. We noted two distinct types of macular changes in 23 of 79 eyes (29.1%) of stage 2 ROP. The first pattern (12/23, 52.2%) was evidenced by foveal pit disruption with large dome shaped foveal edema with large intra-retinal cystic spaces. The second pattern (11/23, 47.8%) had a preserved foveal depression with smaller intra-retinal cystic spaces. Correlation with central foveal thickness was significant. Both patterns resolved by the fifty-second postmenstrual age (PMA). None of the eyes with stage 1 ROP or the normals had either change (p< 0.0001).

Conclusion: This is the first description of macular changes in acute mild ROP imaged on a Spectral Domain OCT. The clinical significance of these changes is currently unknown. We propose the possible clinical significance of these transient foveal changes which are present at the critical time-period of 'fovealization' of the infant macula which may play a role in vision development in adults with ROP historically.