OCT Can Measure Objective Retinopathy of Prematurity Staging Biomarker

Retinal thickness at the vascular-avascular junction measured by OCT can reveal the stage of retinopathy of prematurity in infants.

Optical coherence tomography (OCT) can help reveal the peripheral stage of retinopathy of prematurity (ROP), offering an objective, quantitative biomarker, according to results of a study published in JAMA Ophthalmology. Researchers believe the this finding may have implications for the future of ROP classification.

This study was conducted at the Oregon Health & Science University and evaluated 128 OCT sessions of 50 eye from 25 pediatric patients (average gestational age, 26.7±2.4 weeks; postmenstrual age, 37.3±3.7 weeks; 60.0% girls; birthweight 834.3± 350.3 g). All participants met ROP screening criteria and underwent ultra-wide OCT evaluation between 2021 and April 2022. Retinal thickness OCT measurements at the vascular-avascular junction were evaluated for clinical diagnostic utility.

The researchers found increased axial ridge thickness is indicative of higher ordinal disease classification, with a maximum ridge thickness of 264.2 µm indicating stage 1 ROP (P <.001), 334.2 µm indicating stage 2 ROP (P <.001), and 495.0 µm indicating stage 3 ROP (P <.001). Overall, maximum ridge thickness was correlated with ROP stage labels (r, 0.739; P <.001).

A subset of 4 infants underwent multiple OCT examinations prior to and after intravitreal bevacizumab treatment. The average maximum ridge thickness pretreatment was 342.4 µm (P <.001). It was 394.4 µm at the time of treatment (P =.02), and 304.0 µm 1 to 2 weeks after treatment (P =.002).

OCT may one day be used for ultra-widefield anatomic staging of ROP, more precisely characterizing the degree and extent of peripheral pathology.

“OCT-based measurement of peripheral ridge thickness correlated with image-based stage diagnosis and highlighted the spectrum of vascular pathology in ROP,” according to the researchers. “While not yet widely available, these results suggest that OCT may one day be used for ultra-widefield anatomic staging of ROP, more precisely characterizing the degree and extent of peripheral pathology. OCT is also superior to the ophthalmoscopic examination for identifying early vitreoretinal traction, which means surgical intervention could be timed early to prevent macula involving retinal detachments.”

The major limitations of this study were that the clinical research prototype for obtaining OCT in infants is not commercially available and the fact that the measurement of ridge thickness was performed manually.

Disclosure: Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Nguyen T-T P, Ni S, Ostmo S, et al. Association of optical coherence tomography–measured fibrovascular ridge thickness and clinical disease stage in retinopathy of prematurity. JAMA Ophthalmol. Published online October 13, 2022. doi:10.1001/jamaophthalmol.2022.4173