Search

Purpose: To quantify the macular microvasculature in healthy children of various ages by using optical coherence tomography angiography (OCTA)., Design: Prospective cross-sectional study., Methods: A total of 333 normal children from 4 to 16 years old were included. OCTA was performed on a 3- × 3-mm area centered on the macular region. Vascular density, perfusion density, fovea avascular zone (FAZ) area, FAZ perimeter, and FAZ acircularity index (AI) were measured and adjusted for axial length. Differences were compared among various ages., Results: Among the different age groups, both macular vascular density and perfusion density increased with age (P < .0001 and P = .0028, respectively). After adjustments were made for the spherical equivalent (SE) and axial length, macular vascular density was significantly associated with age (r = 0.183; P = .001) No factors were significantly correlated with the perfusion density after adjustment for the age, SE, or axial length. The FAZ area and FAZ perimeter did not change among groups of different ages. Nevertheless, the AI of FAZ in the 4.00-6.99-year-old group was smaller to that of the 13.00-15.99-year-old group (P = .03). Younger children had significantly higher rates of nonconsecutive vessels branched toward the macular center (P = .0002) and vascular loops contributing to irregular shapes of FAZ (P = .024)., Conclusions: Macular vascular density and perfusion density continuously increase with age in children. Despite the fact that FAZ area and perimeter did not change, the microstructure of FAZ pruned and tended to form a smooth and regular avascular area during development., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: To study the extent of retinal vascularization at birth., Design: Prospective masked observational case series., Methods: One hundred ten neonates, at different weeks of gestation and birth weights (BWs), had dilated fundus evaluation for zone of retinal vascularization by a masked observer. Maternal and neonatal factors were ascertained by a masked pediatrician., Results: Irrespective of risk factors, eight of nine babies who were born at <30 weeks of gestation and at <1500 g BW had immature retina. Those babies who were born at >34 weeks of gestational age and at >1700 g BW had mature retina. Babies who were born between 31 to 34 weeks of gestation and at 1501 to 1700 g BW had variable extent of retinal vascularization at birth. Vascularization was affected by maternal anemia and the need for oxygen for >48 hours., Conclusion: There exists considerable variability in the extent of retinal vascularization in infants who are born between 31 to 34 weeks of gestation. Modifiable maternal and fetal factors could influence extent of this vascularization birth.

A 32-year-old obese woman with hypertension and a three-year history of pseudotumor cerebri developed bilateral juxtapapillary subretinal neovascular membranes. To our knowledge, this is the first reported case of bilateral subretinal neovascular membranes complicating the course of this disease. The subretinal neovascular membrane in the left eye spontaneously involuted, but because the membrane in the right eye threatened the foveola, the patient underwent argon-laser photocoagulation. The subretinal fluid and hemorrhage progressively resolved, the membrane was replaced by fibrous tissue, and visual acuity improved. The pathogenesis of the subretinal neovascular membranes was presumably secondary to pressure deformity of the border of Bruch's membrane at the optic disk, creating a discontinuity of normal anatomic apposition of the chorioretinal layers. This anatomic dehiscence, coupled with hypoxia created by axonal tissue swelling and resultant impaired vascular perfusion of the tissues, led to the development of subretinal neovascular membranes.