The size of the foveal avascular zone is associated with foveal thickness and structure in premature children

Abstract

Purpose. To investigate the foveal avascular zone (FAZ) in the eyes of patients with a history of retinopathy of prematurity (ROP) using optical coherence tomography angiography (OCTA) and to identify associated clinical factors. Patients and methods. Overall, 14 children with a history of laser treatment for ROP, 17 children born prematurely without a history of ROP, and 41 age-matched children born at full-term (age range 7-14 years) were included. OCTA was conducted on an area measuring 3 × 3 mm in the central macula. The area of FAZ in the superficial layer was measured. Foveal thickness (FT), ganglion cell complex thickness, and the presence of inner retinal layer (IRL) at the fovea were evaluated. Results. There were significant differences in FT and FAZ size among patients (P<0.001). The eyes of patients that had been treated for ROP showed the smallest FAZ and greatest FT. Univariate analyses demonstrated that the area of FAZ was not correlated with visual acuity (P=0.078) but with gestational age (GA) (P=0.001), birth weight (P=0.013), the presence of IRL (P<0.001), and FT (P<0.001). Multivariate regression analyses showed that the area of FAZ was significantly associated with GA, the presence of IRL, and FT (P=0.03, P=0.01, P<0.001, respectively). Conclusion. The eyes of preterm children had small FAZ, and this reduction in area was associated with greater FT, the presence of IRL, and lower GA.