Outer Retinal Structural Alternation and Segmentation Errors in Optical Coherence Tomography Imaging in Patients With a History of Retinopathy of Prematurity

PURPOSE: To evaluate retinal anatomy and segmentation errors from spectral-domain optical coherence tomography (SD-OCT) imaging in school-aged children. DESIGN: A prospective cohort study in a referral medical center. METHODS: One hundred thirty-three eyes of 133 patients were enrolled. Patients were grouped as those who were treated for retinopathy of prematurity (ROP) (ROP-Tx group); those with spontaneously regressed ROP (ROP-non-Tx group); other premature patients (premature group); and full-term age-matched children (full-term group). Anatomy and segmentation errors of retina were evaluated by SD-OCT. RESULTS: The mean age at assessment was 9.5 years (range, 4-16 years). The external limiting membrane (ELM) and the cone outer segment tips (COST) line were least frequently identified in patients of the ROP-Tx group (65.2% and 47.8%, P = .002 and P < .001, respectively). The visual acuity of the patients did not correlate significantly with the absence of COST line (P = .140) but correlated with the absence of ELM (P < .001). The presence of artifacts, including misidentification of the inner retina, misidentification of the outer retina, out-of-register artifacts, off-center scans, and degraded scan images, was observed to range from 0.6% to 50.0% in 4 groups of patients. All types of errors occurred more frequently in the ROP-Tx group than in the full-term group (all P < .05). CONCLUSIONS: Outer retinal abnormalities were commonly observed in the ROP-Tx group. The higher segmentation errors in the ROP-Tx group might be related to fine structural abnormalities in the outer retina. Future studies are needed to investigate the mechanisms for these structural changes. (C) 2016 Elsevier Inc. All rights reserved.