Optical Coherence Tomography in Retinopathy of Prematurity

*Artemiy Kokhanov, Ye He, Pooja Nikki Bisarya and Irena Tsui*

## **Abstract**

Retinopathy of prematurity (ROP) is a disease that uniquely affects prematurely born infants. This disease is caused by disordered retinal vascular proliferation and may lead to blindness. The gold standard for ROP screening, diagnosis and monitoring is indirect ophthalmoscopy examination. Optical coherence tomography (OCT) has recently been used in ROP affected infants and children in research settings. It has provided further understanding of retinal vascular development and visualization of subtle subclinical features that otherwise go undetected. In school-aged children, OCT has become an essential tool for monitoring macular sequelae of ROP such as retained inner retinal layers, epiretinal membrane, subretinal fluid, and retinoschisis. This chapter reviews the current use of OCT in infants with ROP as well as older children with history of ROP.

**Keywords:** cystoid macular edema, foveal avascular zone, optical coherence tomography, plus disease, prematurity, retinal detachment, retinopathy of prematurity, retinoschisis

## **1. Introduction**

Retinopathy of prematurity (ROP) is a disorder unique to prematurely born neonates. It stems from abnormal retinal vascular proliferation which may lead to permanent damage to the retina and retinal detachment. It remains to be the main cause of childhood blindness throughout the world notwithstanding the major progress in management [1]. The first description of ROP came in 1942 by Terry [2]. At the time the condition was called retrolental fibroplasia and was thought to represent persistent fetal vasculature related to prematurity [2]. Afterwards it was determined that those findings were not innate, but rather developed postnatally in response to exogenous factors, such as exposure to oxygen [3]. Judicial use of supplemental oxygen led to reduction in incidence of ROP [4]. The advancements in neonatal care and increased survival of very low and extremely low birth weight neonates in developed countries resulted in the "second wave' of ROP [5]. The "third wave" came with the recent rapid expansion of neonatal services in developing countries where control of complications of preterm birth is lagging [6]. Each year about 32,300 prematurity survivors worldwide are impacted by permanent vision impairment due to ROP [7]. In recent years, with the increased use of OCT, there has been an ever-increasing interest in using optical coherence tomography (OCT) to comprehend ocular development as well as to detect long term macular sequelae of ROP [8]. In this chapter the utilization of OCT in infants and children with ROP will be discussed.
