title: Macular features from spectral-domain optical coherence tomography as an adjunct to indirect ophthalmoscopy in retinopathy of prematurity.
abstract: OBJECTIVE
  To compare vitreoretinal pathology imaged with portable handheld spectral-domain optical coherence tomography (SD-OCT) to conventional indirect ophthalmoscopic examination in neonates undergoing screening for retinopathy of prematurity.
  
  
  METHODS
  Spectral-domain optical coherence tomography images were collected from 76 eyes of 38 neonates during 118 routine retinopathy of prematurity examinations. Imaging sessions in the Neonatal Intensive Care Unit were performed immediately after the subjects underwent a standard ophthalmic examination with indirect ophthalmoscopic by a pediatric ophthalmologist. Masked certified SD-OCT graders evaluated scans for preretinal and retinal findings including material in the vitreous, epiretinal membrane, intraretinal cystoid structures and deposits, optic nerve and vascular features, and severity and location of retinopathy of prematurity. The frequency of detection of these features by clinical examination and evaluation of SD-OCT images was compared to determine potential clinical advantages for each modality.
  
  
  RESULTS
  Portable SD-OCT imaging characterized macular features of retinal cystoid structures in 39% of examinations and epiretinal membrane in 32% of examinations. Neither feature was visualized by indirect ophthalmoscopy in any cases. The clinician using indirect ophthalmoscopy detected stage of retinopathy of prematurity and the presence or absence of Plus or pre-Plus disease. These were not visualized with SD-OCT.
  
  
  CONCLUSIONS
  Spectral-domain optical coherence tomography provides new information about the premature infant retina that is of unknown importance relative to visual development and acuity. As used in this study, SD-OCT does not replace indirect ophthalmoscopy for evaluation of retinopathy of prematurity.
authors.affiliation: Department of Ophthalmology, Duke University Medical Center, Duke University, Durham, North Carolina 27710, USA.
authors.forename: Annie C
authors.initials: AC
authors.lastname: Lee
authors.forename: Ramiro S
authors.initials: RS
authors.lastname: Maldonado
authors.forename: Neeru
authors.initials: N
authors.lastname: Sarin
authors.forename: Rachelle V
authors.initials: RV
authors.lastname: O'Connell
authors.forename: David K
authors.initials: DK
authors.lastname: Wallace
authors.forename: Sharon F
authors.initials: SF
authors.lastname: Freedman
authors.forename: Michael
authors.initials: M
authors.lastname: Cotten
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Toth
mesh_terms: D001724:Birth Weight; D019773:Epiretinal Membrane / Q000175:diagnosis; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008269:Macular Edema / Q000175:diagnosis; D008297:Male; D009887:Ophthalmoscopy / Q000379:methods*; D012160:Retina / Q000473:pathology*; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014822:Vitreous Body / Q000473:pathology*