Importance Early diagnosis of plus disease is critical in the management of retinopathy of prematurity (ROP). However, there is substantial interexpert disagreement in the diagnosis of plus disease based on vascular changes alone. Information derived from optical coherence tomography (OCT) may help characterize the severity of vascular and structural abnormalities in ROP. Objective To describe integrated visualization of 3-dimensional (3-D) data from investigational swept-source OCT optimized to delineate retinal vascular and microanatomical features in eyes with and without ROP. Design, Setting, and Participants This cross-sectional, observational report of OCT was captured in the prospective Study of Eye Imaging in Preterm Infants (BabySTEPS) designed in July 2016 at the Duke Health Intensive Care Nursery. Between December 2018 and August 2019, 2 preterm infants born at 24 and 30 weeks' gestation were enrolled, underwent ROP screening, and were imaged at those screening visits. Data at 36 weeks' postmenstrual age were analyzed via this visualization developed between September 2020 and May 2021. Main Outcomes and Measures Superimposed en face retinal vascular shadow view (RVSV) montages and thickness maps were used along with OCT B-scans to evaluate retinal vasculature and cross-section in eyes with and without ROP. Results In the right eyes of 2 infants, 3-D data were integrated and visualized from investigational bedside OCT imaging at the posterior pole. In the infant who developed type 1 ROP, RVSV-OCT confirmed presence of dilated and tortuous posterior pole vessels, shunting, and incomplete perifoveal vascular development, resulting in a temporal notch of avascular retina in zone 1. The thickness map revealed irregular pockets of thickening and thinning, and integrated visualization outlined the demarcation between thicker vascularized retina and thinner avascular fovea and presence of extraretinal neovascularization overlying elevated vessels in the superior arcades. In the infant without ROP (stage 0), RVSV-OCT revealed no abnormal vascular findings at the posterior pole. The integrated visualization showed a dome-shaped retinal thickening at the fovea, which was confirmed as macular edema. Conclusions and Relevance In 2 preterm infants in BabySTEPS, 3-D visualization of OCT findings during the ongoing ROP disease process demonstrated supplemental information about the retinal vasculature and microanatomy that can be useful to clinicians. These additional details provided by OCT could be integrated into future ROP screening methods with artificial intelligence-based analytics.

中文翻译：

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综合可视化突出显示早产儿视网膜病变的 3 维光学相干断层扫描数据的视网膜变化。

重要性 附加疾病的早期诊断对于早产儿视网膜病变 (ROP) 的管理至关重要。然而，在仅根据血管变化诊断附加疾病方面，专家间存在很大分歧。来自光学相干断层扫描 (OCT) 的信息可能有助于表征 ROP 中血管和结构异常的严重程度。目的 描述来自研究性扫描源 OCT 的 3 维 (3-D) 数据的集成可视化，该数据经过优化以描绘有和没有 ROP 的眼睛的视网膜血管和显微解剖特征。设计、设置和参与者 OCT 的横断面观察报告是在 2016 年 7 月在杜克健康重症监护室设计的早产儿眼部成像前瞻性研究 (BabySTEPS) 中捕获的。2018年12月至2019年8月期间，招募了 2 名妊娠 24 周和 30 周出生的早产儿，进行 ROP 筛查，并在这些筛查访视时进行成像。通过在 2020 年 9 月至 2021 年 5 月期间开发的这种可视化分析了 36 周后月经年龄的数据。主要结果和措施使用叠加的面部视网膜血管阴影视图 (RVSV) 蒙太奇和厚度图以及 OCT B 扫描来评估视网膜血管系统以及有和没有 ROP 的眼睛的横截面。结果 在 2 名婴儿的右眼中，3-D 数据从后极的研究性床边 OCT 成像中得到整合和可视化。在发生 1 型 ROP 的婴儿中，RVSV-OCT 证实存在扩张和扭曲的后极血管、分流和不完整的中心凹周围血管发育，导致 1 区出现无血管视网膜的时间切迹。厚度图显示不规则的增厚和变薄袋，综合可视化勾勒出较厚的血管化视网膜和较薄的无血管中央凹之间的分界，以及在上拱廊中高架血管上方存在视网膜外新血管形成。在没有 ROP 的婴儿（0 期）中，RVSV-OCT 显示后极没有异常血管发现。综合可视化显示中央凹处有圆顶状视网膜增厚，证实为黄斑水肿。结论和相关性 在 BabySTEPS 的 2 名早产儿中，正在进行的 ROP 疾病过程中 OCT 结果的 3-D 可视化展示了对临床医生有用的视网膜血管系统和显微解剖学的补充信息。