ObjectiveTo observe the macular morphological development and thickness of retinal layers in infants. MethodsFifty-eight infants (86 eyes) were randomly selected from neonatal intensive care unit. They were divided into 4 groups according to the corrected gestational age, including <32 weeks group (10 cases, 14 eyes), 33 to 36 weeks group (26 cases, 39 eyes), 37 to 41 weeks group (12 patients, 18 eyes) and ≥42 weeks group (10 cases,15 eyes). Twelve health adults (22 eyes) were randomly selected as adult group. All infants and adults underwent a portable optical coherence tomography (OCT) examination, focus on the macular morphology. The thickness of 9 retinal layers at fovea and parafovea (750 μm, 1500 μm from central fovea) were measured, including retinal neurepithelium layer, the inner retina, the outer retina, nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and inner nuclear layer. The correlation between retinal thickness and corrected gestational age was analyzed. ResultsMacular fovea was shallow in early infancy, and then form a mature macular fovea finally with corrected gestational age. The outer retina structure was more mature than the inner retina of infants. With the increase of the corrected gestational age, the following structures gradually developed including the outer limiting membrane (OLM), the junction of inner and outer segment of photoreceptor (IS/OS), the outer segment of photoreceptor/retinal pigment epithelium layer (OS/RPE). The earliest corrected gestational age to detect the OLM, IS/OS, OS/RPE was 32+6, 35, 47+6 weeks respectively. The RPE and choroid layer became thicker gradually. There were no statistical differences between infants group and adults group (P>0.01) for the following thickness measurements, including inner retina at 750 μm parafovea, nerve fiber layer at 1500 μm parafovea, ganglion cell layer at central fovea and parafovea (750 μm, 1500 μm). The thickness of other retinal layers was different between different sites, between different corrected gestational ages, and between infants and adults groups (P<0.01). Correlation analysis found that, except of retinal ganglion cell layer, the thickness of other retinal layers was correlated with the corrected gestational age (P<0.05). ConclusionsMacular fovea is shallow in early infancy, and then form a mature macular fovea finally with corrected gestational age. At infant's early stage, the outer retina of macular is gradually thickening, of which the most obvious variation are the inner nuclear layer and outer nuclear layer. But the development speed of all layers is inconformity.
ObjectiveTo analysis the fundus characteristics of fundus fluorescein angiography (FFA) of retinopathy of prematurity (ROP). MethodsEighty-four cases (168 eyes) who were diagnosed with ROP by a binocular indirect ophthalmoscope were included in the study. Among the 84 cases, there were 2 cases (4 eyes) of stage 1 ROP, 26 cases (52 eyes) of stage 2 ROP, 40 cases (80 eyes) of stage 3 ROP, 4 cases (8 eyes) of stage 4 ROP, and 4 cases (8 eyes) of stage 5 ROP, 9 cases (18 eyes) of plus disease, 8 cases (16 eyes) of aggressive posterior ROP (APROP). All infants received FFA with RetCam Ⅱ under general anesthesia and mydriasis. The retinal vein morphology, capillary filling state, neovascularization morphology and fluorescein leakage were observed. ResultsFFA revealed increased branching, expansion and tortuous peripheral retinal capillaries, increased capillary permeability with a small amount of fluorescein leakage in stage 1 ROP. There was a clear dividing line between the vascular area and the remote avascular area. In stage 2, the peripheral branches of temporal retinal blood vessels increased, and parallel distributed like a broom. The capillary end anastomosed with each other to form a loop. The fibrous tissues at the lesion edge proliferated as a ridge, with popcorn phenomenon. In stage 3, the ridge continued broadening, and the neovascular fibrous membrane formed breakthrough internal limiting membrane, stretched into the vitreous with a lot of fluorescein leakage. The ridge and remote avascular zone demarcated clearly. In stage 4 and 5, the vessel changes had similar phenomenon with the stage 2 and 3 in undetached retina, but the vessels in the detached retina expanded with fluorescein leakage. As for plus disease, the retinal arterioles in the posterior pole were tortuous, there were a large number of non-perfusion area in the peripheral retina with hemorrhage and obscured fluorescence. The retinal vessels in posterior pole in AP-ROP were also tortuous, and the capillaries were extreme expanded, while there were very few tortuous vessels and no capillary formation in the other part of retina.At the avascular zone boundaries, there were a large group of neovascularization with fluorescein leakage. ConclusionsThe demarcation line separating the avascular from the vascularized retinal regions is formed in stage 1, 2 and 3, and the amount of fluorescein leakage gradually increase from stage 1 to stage 3 ROP. The detached retina of stage 4 and stage 5 has an unclear focal length in the FFA. The plus disease mainly has arteriolar tortuosity in the posterior pole retina. In the AP-ROP cases, both of the arterioles and venules in posterior pole of retina are tortuous and expanding with neovascularization leakage of fluorescein.