Intraoperative OCT Angiography in Pediatric Patients with Persistent Fetal Vasculature

Natasha F S da Cruz; Jesse D Sengillo; Julia L Hudson; Piero Carletti; Giselle de Oliveira; Catherin I Negron; Marley B Felder; Audina M Berrocal

doi:10.1016/j.oret.2023.07.019

Intraoperative OCT Angiography in Pediatric Patients with Persistent Fetal Vasculature

Ophthalmol Retina. 2023 Dec;7(12):1109-1115. doi: 10.1016/j.oret.2023.07.019. Epub 2023 Jul 25.

Authors

Natasha F S da Cruz¹, Jesse D Sengillo¹, Julia L Hudson¹, Piero Carletti¹, Giselle de Oliveira¹, Catherin I Negron¹, Marley B Felder¹, Audina M Berrocal²

Affiliations

¹ Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
² Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: ABerrocal@med.miami.edu.

PMID: 37499903
DOI: 10.1016/j.oret.2023.07.019

Abstract

Purpose: To describe abnormalities of the optic nerve microvasculature in patients with persistent fetal vasculature (PFV) and their fellow eyes using OCT angiography (OCTA).

Design: Cross-sectional study.

Subjects: Fifty eyes of 25 patients with PFV who underwent prospective imaging using supine OCTA during examination under anesthesia at Bascom Palmer Eye Institute from March 1, 2019, to December 31, 2022.

Methods: OCT angiography images of the optic nerve of the included patients were analyzed with a primary focus on blood flow. Demographic, clinical, and treatment factors were compared with morphologic changes in the optic disc microvasculature.

Main outcome measures: Prevalence of optic nerve microvascular abnormalities on OCTA in the affected and fellow eyes of patients with PFV.

Results: A total of 50 eyes from 25 patients were reviewed, and 28% (7/25) met image quality criteria for OCTA analysis. Optic nerve OCTA showed a persistent hyaloid artery (PHA) in all (7/7) PFV eyes analyzed. Of these, flow on OCTA was detectable in 57% (4/7). A Bergmeister papilla was evident in 100% (25/25) fellow eyes, of which flow was detected in 68% (17/25). Fluorescein angiography (FA) demonstrated blood flow within the stalk in 40% (10/25) of PFV eyes and within the Bergmeister papilla in 25% (6/25) of fellow eyes. Similar findings of abnormal blood flow and presence of fibrovascular stalk were seen in both treatment-naïve and treated groups.

Conclusions: OCT angiography allows for high-resolution visualization of subtle vascular abnormalities that are not readily apparent using RetCam FA and may serve as a useful noninvasive test to confirm the patency of the PHA and Bergmeister papilla in children. The results of the present study suggest that PFV may be a bilateral and asymmetric process.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Examination under anesthesia; Fluorescein angiography; OCT angiography; Pediatric retina; Persistent fetal vasculature.

MeSH terms

Child
Cross-Sectional Studies
Fluorescein Angiography / methods
Humans
Persistent Hyperplastic Primary Vitreous* / diagnosis
Prospective Studies
Tomography, Optical Coherence / methods