OSLI Retina

August 2020

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August 2020 · Vol. 51, No. 8 475 malities have been noted in both the eye and brain. Infants born prematurely, particularly those with CME, have been found to have delayed foveal pho- toreceptor development. 17 Two groups have report- ed lower visual acuity in infants and young chil- dren at 3 months, 9 to 14 months, and 4 to 5 years corrected age with a history of neonatal CME. 15,18 With the retina as an extension of the central ner- vous system, neonatal CME has further been corre- lated with anomalies on brain magnetic resonance imaging and poorer language and motor develop- ment Bayley Scale subscores at 18 to 24 months corrected age. 5,15 More severe CME, quantified by higher FP thickness ratios on OCT imaging, was linked to lower cognitive and motor subscores. 5 In conclusion, the expanded use of portable OCT imaging devices has made visualizing the pre- term macula and investigating CME mechanisms increasingly feasible. We demonstrate the utility of OCT imaging as an adjunct to standard clinical exam for monitoring the preterm retina, as well as consider the roles of VEGF and laser treatment in CME. Taken together with previous studies, this re- port highlights the multi-factorial etiology of mac- ular edema in infants with ROP and the possible role of anti-VEGF should be confirmed with more patients. Larger, more comprehensive, and longitu- dinal studies are needed to better understand the pathogenesis and significance of macular edema in the preterm retina, and how patterns can be used to predict later visual acuity and neurodevelopmental outcomes. REFERENCES 1. Maldonado RS, O'Connell RV, Sarin N, et al. Dynamics of hu- man foveal development after premature birth. Ophthalmol- ogy. 2011;118(12):2315-2325. https://doi.org/10.1016/j.oph- tha.2011.05.028 PMID:21940051 2. Lee AC, Maldonado RS, Sarin N, et al. Macular features from spectral-domain optical coherence tomography as an ad- junct to indirect ophthalmoscopy in retinopathy of prematu- rity. Retina. 2011;31(8):1470-1482. https://doi.org/10.1097/ IAE.0b013e31821dfa6d PMID:21792089 3. Maldonado RS, O'Connell R, Ascher SB, et al. Spectral-domain optical coherence tomographic assessment of severity of cystoid macular edema in retinopathy of prematurity. Arch Ophthalmol. 2012;130(5):569-578. https://doi.org/10.1001/archopthal- mol.2011.1846 PMID:22232366 4. Vinekar A, Avadhani K, Sivakumar M, et al. Understanding clini- cally undetected macular changes in early retinopathy of prematu- rity on spectral domain optical coherence tomography. Invest Oph- thalmol Vis Sci. 2011;52(8):5183-5188. https://doi.org/10.1167/ iovs.10-7155 PMID:21551410 5. Rothman AL, Tran-Viet D, Gustafson KE, et al. Poorer neurode- velopmental outcomes associated with cystoid macular edema identified in preterm infants in the intensive care nursery. Oph- thalmology. 2015;122(3):610-619. https://doi.org/10.1016/j.oph- tha.2014.09.022 PMID:25439600 6. Vajzovic L, Hendrickson AE, O'Connell RV, et al. Matura- tion of the human fovea: correlation of spectral-domain opti- cal coherence tomography findings with histology. Am J Oph- thalmol. 2012;154(5):779-789.e2. https://doi.org/10.1016/j. ajo.2012.05.004 PMID:22898189 7. Bringmann A, Reichenbach A, Wiedemann P. Pathomechanisms of cystoid macular edema. Ophthalmic Res. 2004;36(5):241-249. https://doi.org/10.1159/000081203 PMID:15583429 8. Chen X, Mangalesh S, Tran-Viet D, Freedman SF, Vajzovic L, Toth CA. Fluorescein Angiographic Characteristics of Macular Edema During Infancy. JAMA Ophthalmol. 2018;136(5):538-542. https:// doi.org/10.1001/jamaophthalmol.2018.0467 PMID:29621379 9. Maldonado RS, Freedman SF, Cotten CM, Ferranti JM, Toth CA. Reversible retinal edema in an infant with neonatal hemochroma- tosis and liver failure. J AAPOS. 2011;15(1):91-93. https://doi. org/10.1016/j.jaapos.2010.11.016 PMID:21397814 10. Erol MK, Ozdemir O, Turgut Coban D, et al. Macular findings obtained by spectral domain optical coherence tomography in retinopathy of prematurity. J Ophthalmol. 2014;2014:468653. https://doi.org/10.1155/2014/468653 PMID:25544895 11. Dubis AM, Subramaniam CD, Godara P, Carroll J, Costakos DM. Subclinical macular findings in infants screened for retinopathy of prematurity with spectral-domain optical coherence tomog- raphy. Ophthalmology. 2013;120(8):1665-1671. https://doi. org/10.1016/j.ophtha.2013.01.028 PMID:23672969 12. Young TL, Anthony DC, Pierce E, Foley E, Smith LE. Histopathol- ogy and vascular endothelial growth factor in untreated and diode laser-treated retinopathy of prematurity. J AAPOS. 1997;1(2):105- 110. https://doi.org/10.1016/S1091-8531(97)90008-2 PMID:10875087 13. Al-Taie R, Simkin SK, Douçet E, Dai S. Persistent Avascular Retina in Infants With a History of Type 2 Retinopathy of Pre- maturity: To Treat or Not to Treat? J Pediatr Ophthalmol Stra- bismus. 2019;56(4):222-228. https://doi.org/10.3928/01913913- 20190501-01 PMID:31322711 14. Ni YQ, Huang X, Xue K, et al. Natural involution of acute reti- nopathy of prematurity not requiring treatment: factors associ- ated with the time course of involution. Invest Ophthalmol Vis Sci. 2014;55(5):3165-3170. https://doi.org/10.1167/iovs.13-13744 PMID:24764065 15. Rothman AL, Tran-Viet D, Vajzovic L, et al. Functional Out- comes Of Young Infants With And Without Macular Edema. Retina. 2015;35(10):2018-2027. https://doi.org/10.1097/ IAE.0000000000000579 PMID:25932550 16. Gursoy H, Bilgec MD, Erol N, Basmak H, Colak E. The macu- lar findings on spectral-domain optical coherence tomography in premature infants with or without retinopathy of prematurity. Int Ophthalmol. 2016;36(4):591-600. https://doi.org/10.1007/ s10792-016-0176-9 PMID:26750097 17. Vajzovic L, Rothman AL, Tran-Viet D, Cabrera MT, Freedman SF, Toth CA. Delay in retinal photoreceptor development in very preterm compared to term infants. Invest Ophthalmol Vis Sci. 2015;56(2):908-913. https://doi.org/10.1167/iovs.14-16021 PMID:25587063 18. Vinekar A, Mangalesh S, Jayadev C, et al. Macular edema in Asian Indian premature infants with retinopathy of prematurity: im- pact on visual acuity and refractive status after 1-year. Indian J Ophthalmol. 2015;63(5):432-437. https://doi.org/10.4103/0301- 4738.159879 PMID:26139806

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