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Untersuchung der Aderhautdicke bei aggressiver posteriorer Retinopathia praematurorum, Threshold Disease und Frühgeborenenretinopathie ohne Laserphotokoagulation

Analysis of choroidal thickness in AP-ROP, threshold disease and ROP without laser photocoagulation

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Zusammenfassung

Hintergrund

Spectral-domain-optische Kohärenztomographie (SD-OCT) und „enhanced depth imaging“ (EDI) haben bei der Darstellung der Choroidea an Bedeutung erlangt. Es liegen wenig Informationen über choroidale Veränderungen nach Laserphotokoagulation (LK) bei aggressiver posteriorer Retinopathia praematurorum (AP-ROP) und Threshold Disease (TD) vor.

Patienten und Methoden

In 4 Gruppen wurden 75 Augen retrospektiv untersucht. In der Gruppe 1 waren Patienten mit AP-ROP, in der Gruppe 2 Patienten mit TD, die einer LK unterzogen wurden. Gruppe 3 enthielt Frühgeborene mit ROP ohne LK, Gruppe 4 die Nichtfrühgeborenen. Patienten, die im Alter von ≥ 4 bis < 7 Jahren eine SD-EDI-OCT, Sehleistungsprüfung, einen Befund der vorderen Augenabschnitte und des Fundus, eine Refraktionsbestimmung, eine Messung der axialen Bulbuslänge (ABL) hatten, wurden eingeschlossen. Die subfoveale Aderhautdicke (SFAD), die Sehleistung, das sphärisches Äquivalent (SE) im Alter von ≥ 4 bis < 7 Jahren, Geburtsgewicht (GG), Gestationsalter (GA), ABL und Alter zum Zeitpunkt der Untersuchung wurden zwischen den Gruppen verglichen. Der Einfluss potenzieller Risikofaktoren (GG, GA, ABL, SE und SFAD) auf die Sehleistung wurde mit multivariater linearer Regressionsanalyse untersucht.

Ergebnisse

Bezüglich der SFAD und ABL ergab sich kein signifikanter Unterschied zwischen der Gruppe 2 und 3 sowie zwischen Gruppe 3 und 4. Zwischen den übrigen Gruppen ergab sich ein signifikanter Unterschied. Für die Sehleistung ergab sich zwischen allen Gruppen ein signifikanter Unterschied. Bezüglich des SE fanden wir keinen signifikanten Unterschied zwischen der Gruppe 3 und 4, zwischen den übrigen Gruppen ergab sich ein signifikanter Unterschied. Für das GG und GA ergab sich zwischen allen Gruppen ein signifikanter Unterschied. Das Alter zum Zeitpunkt der Untersuchung zeigte zwischen den Gruppen keinen signifikanten Unterschied. Die multivariate lineare Regressionsanalyse ergab für die Gruppe 1 und 2 den Faktor SFAD, für die Gruppe 3 das GA, für die Gruppe 4 GA, SFAD und ABL als unabhängigen Risikofaktor für die Sehleistung.

Schlussfolgerung

Das Regressionsmodell erklärt für die Gruppen 1 bis 4 31,2 %, 43,5 %, 9,6 % bzw. 69,4 % der Variation der abhängigen Variable LogMar-Visus, d. h., es gibt noch andere Prädiktoren, die die abhängige Variable beeinflussen können.

Abstract

Background

Enhanced depth imaging (EDI) and spectral domain optical coherence tomography (SD-OCT) provide high-definition cross-sectional images of the choroid. Information on alterations in choroidal thickness (CT) after laser photocoagulation (LC) in aggressive posterior retinopathy of prematurity (APROP) and threshold disease (TD) is rare.

Patients and methods

A total of 75 eyes were retrospectively analyzed in 4 groups. Groups 1 and 2 included patients with APROP and TD, respectively, who underwent LC. Group 3 included ROP children who did not undergo LC and group 4 included full-term children. Infants aged ≥4 < 7, who had examination of subfoveal (SF) CT with SD-EDI-OCT, visual acuity (VA), spherical equivalent (SE), anterior segment and fundus examination, axial lenght (AXL) were included. The results of SFCT, VA and SE at the age of ≥ 4 < 7 years, AXL, gestational age (GA), birth weight (BW) and age at examination were compared between the groups. Potential risk factors (GA, BW, SE, AXL and SFCT) influencing visual acuity were evaluated by using multivariate linear regression analysis.

Results

The results of SFCT and AXL were not significantly different between groups 2 and 3 or between groups 3 and 4. There was a significant difference between the other groups for SFCT and AXL and VA was significantly different between all groups. The SE was not significantly different between groups 3 and 4 but there was a significant difference for SE, BW and GA between the groups. Age at examination was not significantly different between the groups. Multivariate linear regression analysis revealed SFCT for groups 1 and 2, GA for group 3 and GA, SFCT and AXL for group 4 as independent risk factors influencing visual acuity.

Conclusion

The regression model used for groups 1–4 explains the variation of the dependent risk factor LogMar VA for groups 1–4 with 31.2 %, 43.5 %, 9.6 % and 69.4 %, respectively. These values expressed in percentage demonstrate that even more predictors may influence the dependent factor LogMar VA than evaluated in the study.

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Danksagung

Wir danken Dr. med. Irfan Vardarli, EU M.Sc. (Epidemiology), für die kritische Durchsicht des Manuskripts und für die wertvolle Unterstützung bei der statistischen Auswertung.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Ophthalmology, Baskent University, Ankara, Turkey

    G. Gökgöz-Özisik, Imren Akkoyun MD, S. Oto, S.A. Bayar & G. Yilmaz

  2. Faculty of Medicine, Division of Neonatology, Department of Pediatrics, Baskent University, Ankara, Turkey

    A. Tarcan

  3. Faculty of Medicine, Department of Anesthesiology and Reanimation, Baskent University, Ankara, Turkey

    Z. Kayhan

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  1. G. Gökgöz-Özisik
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  2. Imren Akkoyun MD
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  3. S. Oto
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  4. S.A. Bayar
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Correspondence to Imren Akkoyun MD.

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Interessenkonflikt

G. Gökgöz-Özisik, I. Akkoyun, S. Oto, S.A. Bayar, A. Tarcan, Z. Kayhan und G. Yilmaz geben an, dass kein Interessenkonflikt besteht.

Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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G. Gökgöz-Özisik und I. Akkoyun teilen sich die gleichberechtigte Erstautorenschaft.

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Gökgöz-Özisik, G., Akkoyun, I., Oto, S. et al. Untersuchung der Aderhautdicke bei aggressiver posteriorer Retinopathia praematurorum, Threshold Disease und Frühgeborenenretinopathie ohne Laserphotokoagulation. Ophthalmologe 113, 58–65 (2016). https://doi.org/10.1007/s00347-015-0058-y

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