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Dome-shaped macula in premature infants visualized by handheld spectral-domain optical coherence tomography
Alex T Legocki1, Yasman Moshiri1, Emily M Zepeda2
1Department of Ophthalmology, University of Washington, Seattle, Washington.
Insights
Dome-shaped macula is common in premature infants, particularly those with lower birth weight and severe retinopathy of prematurity (ROP). Further research is needed to understand the long-term implications of this finding.
Area of Science:
- Ophthalmology
- Neonatology
- Medical Imaging
Background:
- Premature infants are at risk for various ocular complications.
- Retinopathy of prematurity (ROP) is a significant concern in preterm neonates.
- Macular abnormalities can impact visual development.
Purpose of the Study:
- To characterize the prevalence and features of dome-shaped macula in premature infants.
- To identify associated clinical findings and risk factors.
- To explore potential links between dome-shaped macula and retinopathy of prematurity.
Main Methods:
- Prospective observational cohort study of premature infants undergoing ROP screening.
- Handheld spectral domain optical coherence tomography (SD-OCT) for macular imaging.
- Assessment for dome-shaped macula and other OCT findings; measurement of dome height.
- Correlation with ROP diagnosis, birth weight, and 9-month visual/refractive outcomes.
Main Results:
- Dome-shaped macula was observed in 65% of infants (37 total).
- Mean dome height was 139.0 ± 72.3 μm in measurable eyes (35%).
- Dome-shaped macula was associated with ROP diagnosis (OR 3.03) and severe ROP (OR 4.20).
- Infants with dome-shaped macula had lower birth weight (877g vs 1081g).
Conclusions:
- Dome-shaped macula is a frequent finding in premature infants, detectable via handheld SD-OCT.
- The presence of dome-shaped macula is linked to lower birth weight and more severe ROP.
- The long-term clinical significance of dome-shaped macula in this population remains to be determined.
Purpose:
To describe dome-shaped macula and associated clinical findings in premature infants.
Methods:
This prospective, observational cohort study included a consecutive sample of premature infants screened for retinopathy of prematurity (ROP) with 9-month follow-up. Handheld spectral domain optical coherence tomography (SD-OCT) was performed at the time of ROP screening. Images were assessed for dome-shaped macula, cystoid macular edema, epiretinal membrane, vitreous bands, and punctate hyperreflective vitreous opacities. Dome height measurements were performed in a subset of images. Teller visual acuity and cycloplegic refraction were performed at an adjusted age of 8-10 months.
Results:
Of 37 infants (74 eyes; 49% male; mean gestational age 27.8 ± 3.2 weeks; mean birth weight 949 ± 284 g), 24/37 (65%) demonstrated dome-shaped macula in at least one eye (13 both eyes, 5 right eye only, and 6 left eye only). Of the 74 eyes, 26 (35%) could be reliably measured, with a mean dome height of 139.0 ± 72.3 μm (range, 54-369 μm). Presence of dome-shaped macula was associated with a diagnosis of ROP (P = 0.02; OR, 3.03; 95% CI, 1.18-7.82) and pre-plus or plus disease (P = 0.02; OR, 4.20; 95% CI, 1.05-16.78). Infants with dome-shaped macula had lower birth weight compared with those without (877 vs 1081 g; P = 0.04). No associations with other demographics, OCT findings, and 9-month refractive outcomes were found.
Conclusions:
Dome-shaped macula was frequently identified by handheld SD-OCT in premature infants, especially those with lower birth weight and severe ROP. The long-term clinical significance of this finding is unknown.
