Changes in the microvasculature with active retinopathy of prematurity as evidenced by OCT angiography

Abstract

Purpose: to evaluate the degree of structural lesions of the microvasculature, depending on the stage and type of active ROP with optical coherence tomography (OCT) in angio-mode (OCTA). Material and methods. 63 premature infants (63 eyes) with active ROP were tested by OCT of the retina, of which 30 were tested by OCTA. Additionally, 10 premature infants (10 eyes) without signs of ROP were tested by OCTA. We assessed the area and perimeter of the foveal avascular zone (FAZ), the thickness of the retina in the fovea, the density of the superficialand deep plexuses in the fovea and parafovea, the presence or absence of intraretinal, epiretinal and retinovitreal neovascular complexes. Results. We revealed gross structural and microvascular retinal pathology in children with ROP, which was more pronounced in children with an unfavorable course of the disease. Of these, the most affected were children with a shorter gestational period, i. e , more immature. In children with a favorable type of ROP course, a severe general condition has a serious impact on the child’s microvasculature state. The analysis of the correlation dependences of OCTA on the gestational age, stage and type of active ROP, showed a strong direct correlation between the retinal thickness in the fovea, the density of superficial plexus vessels in the fovea, the area and perimeter of the FAZ, on the one hand, and the course of the disease, which is crucial for the correct choice of management and treatment tactics. Conclusion. The OCTA data allow an objective assessment of the severity of the changes in the retinal vasculature, including its microcirculatory component. The data effectively supplement the clinical picture and help identifying the progressive course o f active ROP at the earliest stages of the pathological process, thereby contributing to timely treatment and good clinical and functional results.

Keywords

• окт-ангиография
• ангиорежим
• активная ретинопатия недоношенных
• микроциркуляторное русло