Choroidal Thickness by Handheld Swept-Source Optical Coherence Tomography in Term Newborns

Purpose: To describe normative values for choroidal thickness in newborns and characterize their relationship to vitreoretinal features. Methods: Term newborns underwent awake, handheld swept-source optical coherence tomography (SS-OCT) in this prospective cohort study. An automated segmentation algorithm followed by manual adjustments measured choroidal thickness at the fovea and five perifoveal locations. Two masked, trained graders, with a third mediating disagreements, analyzed scans for vitreoretinal findings. OCT vitreoretinal findings, including dome-shaped macula, subretinal fluid, punctate hyperreflective vitreous opacities, persistent inner retinal layers, foveal ellipsoid zone, tractional and non-tractional vitreous bands, epiretinal membrane, cystoid macular edema, vessel elevation, scalloped retinal layers, hyporeflective vessels, and retinal spaces, were assessed and correlated with foveal choroidal thickness using a generalized linear mixed model. Results: Fifty-nine eyes of 39 infants (mean gestational age, 39.5 weeks; 18 male, 46%) were included. Mean foveal choroidal thickness was 455.5 +/- 93.9 mu m. Choroid was thinner inferonasally (343.6 +/- 106.2 mu m) compared to superonasally (368.4 +/- 92.9 mu m; P = 0.03) and superotemporally (369.6 +/- 100.6 mu m; P = 0.02). Thinner foveal choroidal thickness was associated with absence of a foveal ellipsoid zone (437.1 +/- 78.5 mu m vs. 553.7 +/- 93.9 mu m; P = 0.02). Choroidal thickness was not significantly associated with other OCT findings. Conclusions: We identified an association between thinner choroid and foveal immaturity. Additional study is needed to determine whether choroidal development impacts visual outcomes. Translational Relevance: Handheld SS-OCT achieved normative measurements for choroidal thickness across the macula in term newborns, providing a foundation for future investigations into the role of choroidal development in infancy.