Semi-Automated Analysis of Dome-Shaped Macula in Preterm and Full-Term Infants Using Handheld Swept-Source Optical Coherence Tomography

PURPOSE . Dome-shaped macula (DSM) is known to occur in highly myopic adults and, recently, preterm infants. This study uses investigational handheld swept-source optical coherence tomography (SS-OCT) to further characterize infantile DSM. METHODS . In this prospective, observational study, preterm infants undergoing retinopathy of prematurity screening and full-term infants within 72 hours of birth were imaged. Two trained graders assessed macular features, including DSM, subretinal fluid, and macular edema. A semi-automated program measured foveal immaturity, dome height, and diameter. RESULTS . Two hundred seventeen imaging sessions from 50 full-term and 30 preterm infants were included (46% female, preterm birth weight 1038 +/- 335 g, and gestational age 28.7 +/- 3.1 weeks). DSM occurred in 40% preterm versus 14% full-term infants (P = 0.01). Mean postmenstrual age at first DSM diagnosis was 38.4 +/- 0.0 weeks among preterm and 40.4 +/- 1.1 weeks among full-term infants (P < 0.001). Dome height and diameter measured 55.67 +/- 44.22 pm and 3583.15 +/- 1090.35 pm for preterm versus 88.37 +/- 44.73 pm and 3581.97 +/- 355.07 pm for full-term infants (P = 0.24 and P = 0.96, respectively). All 27 images (11 preterm and 7 full-term infants) with 3-dimensional analysis had round dome configuration. No other associations were seen, including macular fluid (P = 0.17). CONCLUSIONS . Infants frequently exhibit DSM without an association with macular fluid. Preterm infants were more likely than full-term infants to have DSM. Unlike DSM in children and adults, infantile DSM configuration is mostly round rather than ridge-shaped.