title: Foveal Layer Morphology Detected on Spectral Domain Optical Coherence Tomography and its Correlation with Visual Acuity in Asian Indian Premature Infants in their First Year of Life.
abstract: To report foveal microanatomy imaged on handheld spectral domain optical coherence tomography (SDOCT) and correlate it with visual acuity in Asian Indian premature infants.
  
  
  
  A retrospective analysis of 32 Asian Indian premature infants, 10 with Type 2 retinopathy of prematurity (ROP), were imaged between 3 and 12 months of corrected postmenstrual age (PMA) on the handheld SDOCT (Envisu 2300, Bioptigen, DNC, USA). The foveal findings on these images were correlated with visual acuity measured using Teller acuity cards. The study cohort was divided into three groups based on the corrected age, 3-<6 months, 6-<9 months, and 9-12 months. SDOCT images of the foveal center were analyzed for inner retinal layer (IRL) persistence or fusion and presence of the external limiting membrane (ELM), inner segment-outer segment or the ellipsoid zone (EZ), and the outer segment-retinal pigment epithelium (OS-RPE) layers.
  
  
  
  The mean visual acuity of the three groups was 1.60, 1.63, and 1.23 logMAR, respectively (p < 0.001). Visual acuity significantly correlated with all four layers (IRL fusion, ELM, EZ, and OS-RPE in the 3-<6-month group [p < 0.001], IRL fusion only in 6-<9-month group (p < 0.001), and IRL fusion and EZ in the 9-12-month group (p < 0.001 and p = 0.01, respectively).
  
  
  
  The study provides insights into our understanding of a premature infant's foveal maturation in the first year. Inner retinal fusion or maturation is the most important event that correlates with better visual acuity throughout the first year. In addition, between 9 and 12 months PMA, the completion of the EZ at the foveal center positively influenced visual acuity. The presence of ROP did not influence development of the layers, but the sample size was small for subgroup analysis.
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Chaitra
authors.initials: C
authors.lastname: Jayadev
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Anand
authors.initials: A
authors.lastname: Vinekar
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Shwetha
authors.initials: S
authors.lastname: Mangalesh
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Mathew Kurian
authors.initials: MK
authors.lastname: Kummelil
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Anupama Kiran
authors.initials: AK
authors.lastname: Kumar
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Vasudha
authors.initials: V
authors.lastname: Kemmanu
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Munusamy
authors.initials: M
authors.lastname: Sivakumar
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Padmamalini
authors.initials: P
authors.lastname: Mahendradas
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Kavitha
authors.initials: K
authors.lastname: Avadhani
authors.affiliation: b Faculty of Ophthalmology , Maastricht University , Maastricht , The Netherlands.
authors.forename: Noel
authors.initials: N
authors.lastname: Bauer
authors.affiliation: b Faculty of Ophthalmology , Maastricht University , Maastricht , The Netherlands.
authors.forename: Carroll Ab
authors.initials: CA
authors.lastname: Webers
authors.affiliation: a Department of Ophthalmology , Narayana Nethralaya Eye Institute , Bangalore , India.
authors.forename: Bhujang
authors.initials: B
authors.lastname: Shetty
mesh_terms: D044466:Asian People / Q000208:ethnology; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007234:Infant, Premature; D015995:Prevalence; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology*
keywords: Foveal maturation; hand-held imaging; photoreceptors; retinopathy of prematurity; spectral domain optical coherence tomography