Optical coherence tomography angiography in healthy children: normative data and age-related changes in microvascular structure of the optic disk and macula

FOVEAL AVASCULAR ZONE DEVELOPMENT BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Weighing the Influence of Gestational Age and Neonatal Early Growth Independently of Retinopathy of Prematurity

PURPOSE

Focusing the premature birth and its potential complications, this study analyzes foveal avascular zone (FAZ) measured by optical coherence tomography angiography and its correlation with the severity of prematurity and neonatal growth.

METHODS

A cross-sectional comparative study was performed, involving 71 children school-age with history of prematurity and a full-term children control group. Several variables from the neonatal period were collected, such as gestational age, birth weight, initial weight gain, and retinopathy of prematurity. Optical coherence tomography angiography scans determined FAZ perimeter, circularity, and area on both superficial capillary plexus and deep capillary plexus.

RESULTS

A positive correlation between gestational age and FAZ area and perimeter was identified, with a smaller FAZ ( P < 0.001) in preterm children. Furthermore, scatter plots showed a rising trend for all FAZ values based on gestational age and birth weight. Thus, children with greater weight gain during the first 15 days of life had a larger FAZ ( P < 0.05). Gestational age was also predictive ( P < 0.001) for FAZ area and perimeter, while the retinopathy of prematurity stage was a better predictor ( P < 0.0232) for its circularity.

CONCLUSION

Optical coherence tomography angiography finds discrepancies in FAZ between premature and full-term children, with gestational age and neonatal growth having a greater influence than retinopathy of prematurity itself.

A Quantitative Normative Database for Expanded Field Swept-source OCT Angiography in the Pediatric Population

BACKGROUND AND OBJECTIVE

To report quantitative vascular metrics of healthy control eyes of children, using expanded field swept-source optical coherence tomography angiography (SS-OCTA), as a baseline to compare with pathologic findings.

PATIENTS AND METHODS

A cross-sectional observational study of healthy eyes of children (age 6 to 18) who were imaged on the PLEX Elite 9000 instrument at 100-kHz scanning rate using 3 × 3-mm, 6 × 6-mm, and 12 × 12-mm protocols centered on the fovea (2019 to 2023). Scans were uploaded to the ARI Network (Zeiss Portal v5.4) and processed with the macular density algorithm (v.0.7.3.3) to calculate vessel density (VD) and vessel skeletonized density (VSD) in the superficial capillary plexus (SCP), deep capillary plexus, and whole retina (WR) and foveal avascular zone (FAZ) metrics.

RESULTS

Forty-eight eyes of 39 children (72% male) were included. Median age was 14 years (interquartile range 10 to 16). Male sex was associated with lower VD and VSD compared to female sex (P < 0.05). Older age was associated with higher VD and VSD (6 × 6-mm) (P < 0.05) and lower FAZ circularity (P = 0.017). Non-Hispanic White children had a lower VD and VSD of the SCP in the inner superior ring (3 × 3-mm), a higher VD and VSD of the SCP and WR in the central ring (6 × 6-mm), and a lower FAZ area (6 × 6-mm) (P < 0.05).

CONCLUSIONS

This study presents a database for expanded field vascular metrics in pediatric subjects across various angiogram sizes. The VD increases throughout childhood and the FAZ circularity diminishes. Future studies using SS-OCTA will need to account for influencing factors such as sex, age, race, and ethnicity. [Ophthalmic Surg Lasers Imaging Retina 2025;56:212-218.].

Papillary and peripapillary vascular densities and corresponding correlation with peripapillary retinal thicknesses using optical coherence tomography angiography in healthy children and adolescents

To evaluate the peripapillary retinal thickness (PPRT), vascular density (PPVD), and disc vascular density (PVD) and their correlations in normal healthy children using optical coherence tomography angiography (OCTA). This was a cross-sectional study of 70 eyes from 36 normal healthy children aged 6-18 years who performed optic nerve head scans using OCTA. The PPRT included the peripapillary nerve fiber layer (PP-RNFLT), inner retina (PP-IRT), middle retinal thickness, and outer retinal thicknesses. The PP-RNFLT and PP-IRT were not significantly different between males and females. Superior nasal peripapillary RNFLT and IRT were significantly affected by age (ANOVA, P > 0.05). The PP-IRT and PP-RNFLT were lower in the 7-11 years old group in comparison with the other 3 groups (Post hoc Tukey test, P value < 0.05). Age and sex-matched PVD were not correlated with PPVD (partial correlation, P > 0.05). PPRT was not correlated with PVD, PPVD, superficial and deep retinal vascular densities, and choroidal vascular density. This study demonstrated that PPRT appears to change during growth in childhood. Superior nasal PPRT was affected more in the groups, decreasing from less than 7 years old to 7-11 years old and then back to pre-reduction values after 11 years old.

OCT-Angiography Findings in Children with Anisometropic Amblyopia

PURPOSE

The purpose of this prospective study is to show findings of OCT angiography in children with anisometropic amblyopia with a statistically significant difference, regardless of the type of refractive disorder, between the amblyopic and the fellow eye. This research aimed to establish whether there is a difference in vascular density [VD] and size of the foveal avascular zone [FAZ] in the superficial capillary plexus [SCP].

METHODS

All children between 9 and 18 years of age who were treated at the Outpatient Clinic for Orthoptics and Pleoptics of the Department of Ophthalmology, University Medical Centre Maribor from January 2020 to December 2022 due to unilateral anisometric amblyopia were enrolled in our study. Fourteen children met the criteria. Cirrus 5000 high-resolution OCT with AngioPlex OCT angiography was used to analyze the size of the FAZ and VD in the SCP and TCS. The paired t-test or Wilcox signed-rank test [p < 0.05] was used for statistical analysis of each parameter between the amblyopic and fellow eye.

RESULTS

Mean child age was 13 years ± 2.9 and ranged from 9 to 18 years. Most of the children [85.7%] were boys. The VD of the SCP did not show statistically significant differences between the visually impaired and control eyes [p = 0.328]. The comparison of the FAZ area between the two eyes was also not statistically significant [p < 0.808]. There was also no statistically significant difference in central macular thickness [TCS] [p < 0.291].

CONCLUSIONS

Our research results show no statistically significant differences in the VD and the FAZ of the SCP, and in the TCS between the amblyopic and fellow eye in children with unilateral anisometropic amblyopia. Our research did not confirm the results of certain previous studies in which a lower density of the capillary network was present in the visually impaired eye. Further studies with more children are necessary to confirm our results.

Quantitative analysis of retinal microvascular structure and correlation with ocular parameters: A normative database of pediatric OCT angiography

PURPOSE

To analyze the vascular structure of the healthy pediatric population using optical coherence tomography angiography (OCTA), and to investigate its relationship with ocular parameters.

MATERIALS AND METHOD

This cross-sectional, prospective study included 142 eyes of 71 healthy subjects aged 8-18 years. All patients underwent a complete ocular assessment, biometric evaluation and OCTA analysis. Anterior chamber depth, axial length, corneal thickness values were also reported and their relationship with OCTA measurements was evaluated.

RESULTS

There was no statistical difference between girls and boys in terms of demographic characteristics (p>0.05). Neither vascular density in the deep and superficial capillary plexus nor FAZ area was significantly related to the ocular parameters or age of any patient in the study.

CONCLUSIONS

Despite the relatively small number of participants, this study may represent normative data for the Turkish pediatric population. It was also shown that vascular density and FAZ area in childhood are not affected by age, axis length, anterior chamber depth, cornea and foveal thickness.