Assessment of Macular Microvasculature in Healthy Eyes of Infants and Children Using OCT Angiography.
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2019-12
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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.
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Hsu, S Tammy, Hoan T Ngo, Sandra S Stinnett, Nathan L Cheung, Robert J House, Michael P Kelly, Xi Chen, Laura B Enyedi, et al. (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.
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Lejla Vajzovic
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. Her research interests span from pediatric retinal diseases such as retinopathy of prematurity to adult diseases such as age-related macular degeneration, diabetic retinopathy and venous occlusive diseases, as well as vitreoretinal surgical topics such as retinal tears, retinal detachments, macular holes and macular puckers.
In addition, Dr. Vajzovic is interested in cutting edge technologies and recovery of vision in hereditary and common retinal diseases with gene-therapy, stem cell technology and retinal implants. She is a co-director of the Duke Pediatric Retina and Optic Nerve Center, and directs the Duke Center for Artificial and Regenerative Vision, where she performs gene-therapy delivery, and implantation of the Argus II “bionic eye” to restore vision to individuals with total blindness.
An influential educator, she organizes and directs several highly successful national and international courses, including the first-of-its-kind Advances in Pediatric Retina Course at Duke and the international Duke Fellows Advances in Vitreous Surgery Course. She is director of prestigious Duke Vitreoretinal Surgical Fellowship and director of Duke Eye Center’s Continuing Medical Education program.
Dr. Vajzovic completed her vitreoretinal fellowship training at Duke and residency training at Bascom Palmer Eye Institute in Miami, FL. While in training, she received Heed Fellowship Award, Society of Heed Fellows Award and Retina Society Research Award. She is active on the Women in Ophthalmology Board of Directors where she serves as a Treasurer and a Chair of Clinical Trial Training Program. In addition, she serves as a Retina Society AAO Council Representative. She is elected member of the Retina Society, Macula Society and Club Jules Gonin Society. Dr. Vajzovic has been awarded the American Academy of Ophthalmology Achievement Award, American Society of Retina Specialists Senior Honor Award, Women in Ophthalmology Emerging Leader Award and Emerging Leader Award by Duke University School of Medicine and Duke Medical Alumni Association.
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