Spectral optical coherence tomography-angiography for structural and microcirculatory retinal disorders assessment in aggressive posterior retinopathy of prematurity

Purpose. To identify the structural and microvascular changes in the retina in children with aggressive posterior retinopathy of prematurity (ROP) with early and pronounced clinical features using spectral optical coherence tomography (SOCT) with angiography function. Material and methods. SOCT was performed in 40 premature infants (40 eyes) with aggressive posterior ROP, born at 25–28 weeks gestation, with a birth weight of 680–1350 g. 15 infants had early clinical features, optical coherence tomography with angiography function (OCT-A) was performed in 4. 25 infants had pronounced clinical features, OCT-A was performed in 3. The comparison group included 10 premature infants (10 eyes) without signs of ROP, as well as 23 children (23 eyes) with an unfavorable type of stage 3 of classical active ROP. Results. Early clinical features of aggressive posterior ROP were characterized by the absence of an avascular zone in fovea, vasodilation of the superficial and deep retinal plexus, the presence of intraretinal neovascularization in the perifovea, and multiple arteriolo-venular shunts. The severity of the pathological process in children with pronounced clinical features of aggressive posterior ROP reflected the development of massive neovascularization affecting all structures of the vitreoretinal interface, as well as the presence of areas of retinoschisis, indicating a high risk of the retinal detachment. Conclusion. The studies revealed gross structural and microvascular retinal pathology in children with aggressive posterior ROP at an early stage already, which indicates the indisputable importance of the earliest diagnosis, and, consequently, earlier treatment, which plays a key role in creating favorable conditions for the visual functions development. Key words: spectral optical coherence tomography-angiography, aggressive posterior retinopathy of prematurity