PMID- 21940051
OWN - NLM
STAT- MEDLINE
DCOM- 20120126
LR  - 20220318
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Print)
IS  - 0161-6420 (Linking)
VI  - 118
IP  - 12
DP  - 2011 Dec
TI  - Dynamics of human foveal development after premature birth.
PG  - 2315-25
LID - 10.1016/j.ophtha.2011.05.028 [doi]
AB  - PURPOSE: To determine the dynamic morphologic development of the human fovea in 
      vivo using portable spectral domain-optical coherence tomography (SD-OCT). 
      DESIGN: Prospective, observational case series. PARTICIPANTS: Thirty-one 
      prematurely born neonates, 9 children, and 9 adults. METHODS: Sixty-two neonates 
      were enrolled in this study. After examination for retinopathy of prematurity 
      (ROP), SD-OCT imaging was performed at the bedside in nonsedated infants aged 31 
      to 41 weeks postmenstrual age (PMA) (= gestational age in weeks + chronologic 
      age) and at outpatient follow-up ophthalmic examinations. Thirty-one neonates met 
      eligibility criteria. Nine children and nine adults without ocular pathology 
      served as control groups. Semiautomatic retinal layer segmentation was performed. 
      Central foveal thickness, foveal to parafoveal (FP) ratio (central foveal 
      thickness divided by thickness 1000 mum from the foveal center), and 3-dimensional 
      thickness maps were analyzed. MAIN OUTCOME MEASURES: In vivo determination of 
      foveal morphology, layer segmentation, analysis of subcellular changes, and 
      spatiotemporal layer shifting. RESULTS: In contrast with the adult fovea, several 
      signs of immaturity were observed in the neonates: a shallow foveal pit, 
      persistence of inner retinal layers (IRLs), and a thin photoreceptor layer (PRL) 
      that was thinnest at the foveal center. Three-dimensional mapping showed 
      displacement of retinal layers out of the foveal center as the fovea matured and 
      the progressive formation of the inner/outer segment band in the opposite 
      direction. The FP-IRL ratios decreased as IRL migrated before term and minimally 
      after that, whereas FP-PRL ratios increased as PRL subcellular elements formed 
      closer to term and into childhood. A surprising finding was the presence of 
      cystoid macular edema in 58% of premature neonates that appeared to affect inner 
      foveal maturation. CONCLUSIONS: This study provides the first view into the 
      development of living cellular layers of the human retina and of subcellular 
      specialization at the fovea in premature infant eyes using portable SD-OCT. Our 
      work establishes a framework of the timeline of human foveal development, 
      allowing us to identify unexpected retinal abnormalities that may provide new 
      keys to disease activity and a method for mapping foveal structures from infancy 
      to adulthood that may be integral in future studies of vision and visual cortex 
      development. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be 
      found after the references.
CI  - Copyright (c) 2011 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Maldonado, Ramiro S
AU  - Maldonado RS
AD  - Department of Ophthalmology, Duke University School of Medicine, Durham, North 
      Carolina 27710, USA. Cynthia.toth@duke.edu
FAU - O'Connell, Rachelle V
AU  - O'Connell RV
FAU - Sarin, Neeru
AU  - Sarin N
FAU - Freedman, Sharon F
AU  - Freedman SF
FAU - Wallace, David K
AU  - Wallace DK
FAU - Cotten, C Michael
AU  - Cotten CM
FAU - Winter, Katrina P
AU  - Winter KP
FAU - Stinnett, Sandra
AU  - Stinnett S
FAU - Chiu, Stephanie J
AU  - Chiu SJ
FAU - Izatt, Joseph A
AU  - Izatt JA
FAU - Farsiu, Sina
AU  - Farsiu S
FAU - Toth, Cynthia A
AU  - Toth CA
LA  - eng
GR  - UL1 RR024128/RR/NCRR NIH HHS/United States
GR  - UL1 RR024128-01/RR/NCRR NIH HHS/United States
GR  - 1UL1 RR024128-01/RR/NCRR NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20110921
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
CIN - Ophthalmology. 2011 Dec;118(12):2313-4. PMID: 22136673
CIN - Ophthalmology. 2012 Jun;119(6):1288-9.e1; author reply 1289-90.e1. PMID: 22656902
MH  - Adolescent
MH  - Adult
MH  - Cell Movement
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Fovea Centralis/*growth & development
MH  - Gestational Age
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - Infant
MH  - Infant, Newborn
MH  - Infant, Premature/*growth & development
MH  - Macular Edema/diagnosis
MH  - Male
MH  - Middle Aged
MH  - Pregnancy
MH  - Premature Birth/*pathology
MH  - Prospective Studies
MH  - Time Factors
MH  - Tomography, Optical Coherence
MH  - Young Adult
PMC - PMC3496560
MID - NIHMS301039
EDAT- 2011/09/24 06:00
MHDA- 2012/01/27 06:00
PMCR- 2012/12/01
CRDT- 2011/09/24 06:00
PHST- 2011/02/08 00:00 [received]
PHST- 2011/05/09 00:00 [revised]
PHST- 2011/05/10 00:00 [accepted]
PHST- 2011/09/24 06:00 [entrez]
PHST- 2011/09/24 06:00 [pubmed]
PHST- 2012/01/27 06:00 [medline]
PHST- 2012/12/01 00:00 [pmc-release]
AID - S0161-6420(11)00475-1 [pii]
AID - 10.1016/j.ophtha.2011.05.028 [doi]
PST - ppublish
SO  - Ophthalmology. 2011 Dec;118(12):2315-25. doi: 10.1016/j.ophtha.2011.05.028. Epub 
      2011 Sep 21.