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Fluorescein Angiographic Characteristics of Macular Edema During Infancy.

Publication ,  Journal Article
Chen, X; Mangalesh, S; Tran-Viet, D; Freedman, SF; Vajzovic, L; Toth, CA
Published in: JAMA Ophthalmol
May 1, 2018

IMPORTANCE: Macular edema during infancy, a subclinical feature identified in premature infants by handheld spectral-domain optical coherence tomography (SD-OCT), has been associated with poorer visual acuity and neurodevelopmental outcomes. Features of macular edema on fluorescein angiography (FA) are needed to understand its pathophysiology, but to date have not been reported previously. OBJECTIVE: To investigate the FA features of macular edema during infancy. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review was conducted of 8 infants at Duke Eye Center who received simultaneous SD-OCT and FA imaging from July 1, 2011, to June 30, 2017. Research and clinical care images were obtained during examination of the infants under anesthesia or at the bedside in the neonatal intensive care unit. MAIN OUTCOMES AND MEASURES: Side-to-side comparison of research handheld SD-OCT images and clinically indicated FA. RESULTS: Imaging was conducted at a mean (SD) of 42.8 (4.2) weeks' postmenstruation age in the 8 infants (1 [13%] female; 2 [25%] African American; 6 [75%] white). Examination of the FA and SD-OCT images found (1) no macular fluorescein leakage in 3 eyes of 2 infants with retinopathy of prematurity without macular edema and 1 eye with a single cyst, (2) equivocal fluorescein leakage in 2 eyes of 1 infant with mild macular edema, (3) late macular fluorescein leakage in 4 eyes of 2 infants with moderate to severe macular edema, and (4) macular fluorescein leakage from posterior preretinal neovascularization in the macula in 4 eyes of 3 infants with retinopathy of prematurity without macular edema. CONCLUSIONS AND RELEVANCE: This observation of fluorescein leakage in 4 infant eyes with macular edema provides new insights into the possible mechanisms of this subclinical finding. Macular fluorescein leakage could indicate a breakdown or delayed maturation of the blood-retinal barrier or dysfunction of the retinal pigment epithelium. Furthermore, the cross-sectional OCT view aids in identifying preretinal neovascularization, which can also cause focal macular leakage in these infants. This new perspective may improve our understanding and potentially guide future treatments of premature infants with subnormal vision.

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Published In

JAMA Ophthalmol

DOI

EISSN

2168-6173

Publication Date

May 1, 2018

Volume

136

Issue

5

Start / End Page

538 / 542

Location

United States

Related Subject Headings

  • Visual Acuity
  • Tomography, Optical Coherence
  • Retrospective Studies
  • Retinopathy of Prematurity
  • Ophthalmology & Optometry
  • Male
  • Macular Edema
  • Humans
  • Gestational Age
  • Fluorescent Dyes
 

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Chen, X., Mangalesh, S., Tran-Viet, D., Freedman, S. F., Vajzovic, L., & Toth, C. A. (2018). Fluorescein Angiographic Characteristics of Macular Edema During Infancy. JAMA Ophthalmol, 136(5), 538–542. https://doi.org/10.1001/jamaophthalmol.2018.0467
Chen, Xi, Shwetha Mangalesh, Du Tran-Viet, Sharon F. Freedman, Lejla Vajzovic, and Cynthia A. Toth. “Fluorescein Angiographic Characteristics of Macular Edema During Infancy.JAMA Ophthalmol 136, no. 5 (May 1, 2018): 538–42. https://doi.org/10.1001/jamaophthalmol.2018.0467.
Chen X, Mangalesh S, Tran-Viet D, Freedman SF, Vajzovic L, Toth CA. Fluorescein Angiographic Characteristics of Macular Edema During Infancy. JAMA Ophthalmol. 2018 May 1;136(5):538–42.
Chen, Xi, et al. “Fluorescein Angiographic Characteristics of Macular Edema During Infancy.JAMA Ophthalmol, vol. 136, no. 5, May 2018, pp. 538–42. Pubmed, doi:10.1001/jamaophthalmol.2018.0467.
Chen X, Mangalesh S, Tran-Viet D, Freedman SF, Vajzovic L, Toth CA. Fluorescein Angiographic Characteristics of Macular Edema During Infancy. JAMA Ophthalmol. 2018 May 1;136(5):538–542.

Published In

JAMA Ophthalmol

DOI

EISSN

2168-6173

Publication Date

May 1, 2018

Volume

136

Issue

5

Start / End Page

538 / 542

Location

United States

Related Subject Headings

  • Visual Acuity
  • Tomography, Optical Coherence
  • Retrospective Studies
  • Retinopathy of Prematurity
  • Ophthalmology & Optometry
  • Male
  • Macular Edema
  • Humans
  • Gestational Age
  • Fluorescent Dyes