Assessment of Macular Microvasculature in Healthy Eyes of Infants and Children Using OCT Angiography.
Abstract
PURPOSE:To assess macular vasculature in healthy infants and children using OCT angiography
(OCTA). DESIGN:Prospective cross-sectional study. PARTICIPANTS:One hundred thirty-five
normal maculae of 89 healthy infants and children (mean age, 8.5±5.3 years; range,
9 weeks-17 years) treated at the Duke University Eye Center. METHODS:We imaged 135
maculae of 89 pediatric patients using the standard Spectralis tabletop and investigational
Spectralis with Flex module devices, both equipped with investigational OCTA software
(Heidelberg Engineering, Heidelberg, Germany). OCT angiography images of the superficial
vascular complex (SVC) and deep vascular complex (DVC) were analyzed for foveal avascular
zone (FAZ) area and superficial and deep vessel density. We assessed effects of age,
gender, race, axial length (AL), and central subfield thickness on FAZ and vessel
density. Patients with both eyes imaged were assessed for agreement between the FAZ
and vessel densities of the left and right eyes. MAIN OUTCOME MEASURES:The FAZ area,
as well as vessel area density (VAD) and vessel length density (VLD) in the SVC and
DVC. RESULTS:The FAZ varied significantly with race; white patients showed a significantly
smaller FAZ than black patients (mean difference, 0.11 mm2; P = 0.004). The FAZ did
not vary with age, gender, or AL (P > 0.05). In the SVC, VAD and VLD varied significantly
with age (P < 0.001) and AL (R2 = 0.46; P < 0.001) but not gender (P > 0.05). The
SVC VLD was significantly different between races and ethnicities (P = 0.037), but
VAD was not (P < 0.05). In the DVC, VAD and VLD also varied significantly with age
(P < 0.001) and AL (R2 = 0.46; P < 0.001) but not gender or race (P > 0.05). There
was excellent agreement between the right and left eyes for FAZ (intraclass correlation
[ICC], 0.97), SVC VLD (ICC, 1.00), and DVC VLD (ICC, 1.00). CONCLUSIONS:Quantitative
studies of pediatric perifoveal vasculature should consider age, race, and AL. In
eyes with unilateral disease, the perifoveal vasculature in the unaffected eye may
be used as a control comparison because there is excellent agreement between eyes.
Type
Journal articleSubject
Retinal VesselsMacula Lutea
Humans
Tomography, Optical Coherence
Fluorescein Angiography
Prospective Studies
Cross-Sectional Studies
Age Factors
Visual Acuity
Adolescent
Child
Child, Preschool
Infant
Ethnic Groups
Female
Male
Microvessels
Axial Length, Eye
Healthy Volunteers
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https://hdl.handle.net/10161/21187Published Version (Please cite this version)
10.1016/j.ophtha.2019.06.028Publication Info
Hsu, S Tammy; Ngo, Hoan T; Stinnett, Sandra S; Cheung, Nathan L; House, Robert J;
Kelly, Michael P; ... Vajzovic, Lejla (2019). Assessment of Macular Microvasculature in Healthy Eyes of Infants and Children Using
OCT Angiography. Ophthalmology, 126(12). pp. 1703-1711. 10.1016/j.ophtha.2019.06.028. Retrieved from https://hdl.handle.net/10161/21187.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Xi Chen
Assistant Professor of Ophthalmology
Dr. Xi Chen is dedicated to being a clinician-scientist who provides great medical
and surgical care to patients with vitreoretinal diseases, with a research focus in
retinal neurovascular development and disease. Her current research interest is studying
human retinal and vascular development and their coordination using advanced imaging
techniques. Dr. Chen's basic science training in neural development gives her a unique
perspective in her research in human retinal
Nathan Cheung
Assistant Professor of Ophthalmology
Dr. Cheung specializes in pediatric optometry and infant aphakia contact lens fittings.
As a new faculty member at Duke, Dr. Cheung plans to investigate further into various
methods of myopia control and its validity. He is also very interested in establishing
a pediatric optometry residency at Duke to train future optometry residents and equip
them with the skills needed to work in a medical center.
He hopes to make every child’s visit at Duke Eye Center an unforgettabl
Mays Antoine Dairi
Associate Professor of Ophthalmology
1. Pediatric and adult optic neuropathies 2. Optic nerve imaging (mainly optical coherence
tomography) 3. Idiopathic intracranial hypertension 4. Optic neuritis
Laura Barlow Enyedi
Professor of Ophthalmology
Childhood and Adult Strabismus Amblyopia: I am the Duke Prinicipal Investigator for
the Pediatric Eye Disease Investigator Group. I am currently involved in a number
of clinical trials for amblyopia treatment. Strabismus associated with macular translocation
surgery
Sharon Fridovich Freedman
Professor of Ophthalmology
My current research interests include: Childhood glaucomas - With a large referral
practice of children with pediatric glaucomas of all types, Freedman is evaluating
existing and new management strategies for treating refractory congenital and childhood
glaucomas, including the use of pharmacologic agents, as well as modification of surgical
interventions. Freedman has an on-going collaboration with Duke colleagues to study
the genetics of pediatric glaucoma. In addition to an activ
Glenn Jay Jaffe
Robert Machemer M.D. Distinguished Professor of Ophthalmology
I have an active basic and clinical research program. I have been principal investigator
on several funded clinical studies including investigations of an oral ganciclovir
prodrug to treat CMV retinitis and a study to determine the safety of a cyclosporine
sustained drug delivery implant in the treatment of uveitis. I am principal investigator
of an ongoing multicenter trial of a fluocinolone sustained drug delivery implant
to treat patients with severe uveitis and a trial of this same i
Miguel Angel Materin
Professor of Ophthalmology
Ocular oncologist Miguel Materin, MD joined Duke Eye Center as Professor of Ophthalmology
and Director of Ophthalmic Oncology in September 2016. He joins Duke from Yale University
School of Medicine where he was an Associate Professor of Ophthalmology & Visual Science.
Prior to his appointment at Yale, he was at Wills Eye Hospital at Thomas Jefferson
University in Philadelphia, where he served as Director of Diagnostic Studies for
the Ocular Oncology Service. Dr. Materin&rsquo
Grace Prakalapakorn
Associate Professor of Ophthalmology
S. Grace Prakalapakorn, MD, MPH is a pediatric ophthalmology fellowship-trained clinician
scientist with expertise in the diagnosis and treatment of retinopathy of prematurity.
She initially joined the faculty at Duke University as a Clinician Scientist in 2011
and was awarded a K12 Mentored Clinical Scientist Development Program Award by the
department of ophthalmology (2011-2014). She later applied for and was awarded a K23
Career Development Award by the National Institutes of Health (NIH)
Sandra Sue Stinnett
Associate Professor of Biostatistics & Bioinformatics
Analysis of data for ophthalmology including observational studies and clinical trials.
Assessment of reproducibility in grading measurements for ophthalmic studies. Teaching
medical statistics.
Cynthia Ann Toth
Joseph A.C. Wadsworth Distinguished Professor of Ophthalmology
RESEARCH INTERESTS Dr. Toth specializes in the evaluation and surgical treatment
of vitreoretinal diseases in infants, children and adults, and in novel research resulting
in the clinical application of optical coherence tomography (OCT) imaging in surgery
and at the bedside. Her clinical interests and skills include the surgical treatment
of macular diseases (such as, macular hole, epiretinal membrane and vitreomacular
traction), retinal detachment, proliferative diabetic ret
Lejla Vajzovic
Associate Professor of Ophthalmology
Dr. Vajzovic is a vitreoretinal surgeon and tenured Associate Professor of Ophthalmology
at Duke University School of Medicine with expertise in adult and pediatric retinal
diseases and surgery.
Dr. Vajzovic is passionate about translational research and collaborates closely with
Duke biomedical engineers to develop imaging devices to improve ophthalmic care.
She serves as a principal investigator for numerous national clinical trials in early
to late stages of development
Alphabetical list of authors with Scholars@Duke profiles.

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