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Demonstration of anatomical development of the human macula within the first five years of life using bioptigen optical coherence tomography (OCT)

Session Details

Session Title: Imaging I

Session Date/Time: Friday 12/09/2014 | 11:00-13:00

Paper Time: 11:00

Venue: Boulevard D

First Author: : T.Alabduljalil CANADA

Co Author(s): :    C. Toth   A. Reginald   C. Westall   S. Farsiu   A. Arshavsky   W.C. Lam

Abstract Details

Purpose:

To demonstrate the anatomical development of the human macula using the Bioptigen handheld spectral domain (SD) OCT during the first 5 years of age.

Setting:

1- Department of Ophthalmology and Vision Sciences, SickKids hospital, University of Toronto. 2- Departments of Ophthalmology and Biomedical Engineering, Fitzpatrick Institute for Photonics, Vision and Image Processing Laboratory, Duke University.

Methods:

Design: Cross-sectional, prospective, observational case series. Participants: Thirty five normal eyes of 35 full term born children were enrolled. all of which were less than 5 years of age. Methods: Institutional review ethics board approval was obtained at the hospital for sick children to commence the study. Subjects were recruited from the ophthalmology operating room at the hospital of sick children. After obtaining an informed consent from the guardian, the Bioptigen handheld SD OCT was used to image the macula of each eye. The normal eye was selected and the data was analyzed using DOCTRAP (Duke OCT Retinal Analysis Program) v2.1-SF software based on MATLAB (MathWorks, Natick, MA). Retinal thickness maps were generated for the total retinal thickness, the inner retinal layers thickness, the photoreceptor layer thickness and the photoreceptor outer-segment layer thickness. Based on the ETDRS macular map, average thickness measurements were computed at the foveal center and at three circles centered on the fovea: 1mm (S1), 3mm (S2) and 6mm (S3) diameter. Outcome measure: total retinal thickness, inner retinal layers thickness, photoreceptor layer thickness and the photoreceptor outer-segment layer thickness were computed at the foveal center, 1mm (S1), 3mm (S2) and 6mm (S3) diameter circle centered on fovea.

Results:

The inner retinal layer showed increased retina thickness throughout the first 5 years of life in all layers approaching statistical significance at the foveal center (p= 0.097). Interestingly the photoreceptor layer showed thickening in the first 24 months of age at the fovea (p=0.0663), S1(p=0.0163) and S2 (p=0.0036) regions. This photoreceptor development plateaus beyond 24 months of age.

Conclusions:

The Bioptigen handheld SD OCT is an accurate imaging tool to image macular development in children below five years of age. Consistent with previous histopathological studies, the Bioptigen handheld SD OCT has demonstrated in-vivo continued macular development in the first five years of age. We propose that the macular photoreceptor layer matures anatomically before the inner retinal layers. We further propose that 24 month of age is an important developmental milestone for photoreceptors development in the human macula. Our study provides the first in-vivo evidence of macular changes in full term children and reports normative data for macular thickness in this early age group.

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