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Vitreous findings may play future role in ROP screening
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SAN DIEGO — Hyperreflective vitreous opacities seen on hand-held OCT are strongly correlated with the presence of retinopathy of prematurity, worsening ROP stage and plus disease, according to a study.
“This is important because their presence could be a marker for advanced ROP and allow us to develop a noninvasive screening tool for ROP someday,” Emily M. Zepeda, MD, said at the American Association for Pediatric Ophthalmology and Strabismus annual meeting.
Zepeda and colleagues at University of Washington, Seattle, undertook a prospective observational study to characterize punctate hyperreflective vitreous opacities as seen on hand-held OCT (Envisu C2300, Leica) and to evaluate whether vitreous opacities correlate with worsening ROP stage and other vitreoretinal pathologies.
Ninety-three infants requiring ROP screening at two large university hospitals underwent same-day, unsedated OCT imaging with the infant in the supine position, followed by clinical examination.
Two trained graders, who were masked to the clinical assessment, looked for vitreous bands and opacities as well as cystoid macular edema and epiretinal membranes in each scan of the right eye of the infants from 307 total imaging sessions. Agreement between graders was 91% (P < .001), with disagreement mediated by a third trained grader as a tiebreaker.
“We analyzed infants who had ever developed opacities in their right eye and compared them with those who did not,” Zepeda said.
Evidence of vitreous opacity in the right eye was seen in 33% of the infants at least once during their imaging; on clinical examination, 38% of the screened infants had ROP, but only six had type 1 ROP requiring treatment, she said. Worst stage observed was stage 3.
“Our study is an observational study. Nevertheless, the study had high interobserver agreement and is one of the first to report on vitreous findings in infants screened for ROP,” she said.
Future direction for this research will be to quantify the number of opacities and change over time and to correlate the number of opacities to stage of ROP, she said. – by Patricia Nale, ELS
Reference:
Zepeda EM. Punctate hyperreflective vitreous opacities visualized by handheld spectral domain optical coherence tomography in premature infants screened for retinopathy of prematurity. Presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; March 28 to 31, 2019; San Diego.
Disclosure: Zepeda reports no relevant financial disclosures.