Semi-Automated Analysis of Foveal Maturity in Premature and Full-Term Infants Using Handheld Swept-Source Optical Coherence Tomography

Purpose: To develop a semi-automated method of measuring foveal maturity using investigational handheld swept source-optical coherence tomography (SS-OCT).Methods: In this prospective, observational study, full-term newborns and preterm infants undergoing routine retinopathy of prematurity screening were imaged. Semi -automated analysis measured foveal angle and chorioretinal thicknesses at the central fovea and average two-sided parafovea by three-grader consensus, correlating with OCT features and demographics.Results: One hundred ninety-four imaging sessions from 70 infants were included (47.8% girls, 37.6 & PLUSMN; 3.4 weeks postmenstrual age, 26 preterm infants with birth weight 1057 & PLUSMN; 325.0, gestational age 29.0 & PLUSMN; 3.0 weeks). Foveal angle (96.1 & PLUSMN; 22.0 degrees) steepened with increasing birth weight (P = 0.003), decreasing inner retinal layer thick-ness, and increasing gestational age, postmenstrual age, and foveal and parafoveal choroidal thickness (all P < 0.001). Inner retinal fovea/parafovea ratio (0.4 & PLUSMN; 0.2) corre-lated with increasing inner foveal layers, decreasing postmenstrual age, gestational age, and birth weight (all P < 0.001). Outer retinal F/P ratio (0.7 & PLUSMN; 0.2) correlated with ellip-soid zone presence (P < 0.001), increased gestational age (P = 0.002), and birth weight (P = 0.003). Foveal (447.8 & PLUSMN; 120.6 microns) and parafoveal (420.9 & PLUSMN; 109.2) choroidal thicknesses correlated with foveal ellipsoid zone presence (P = 0.007 and P = 0.01, respectively), postmenstrual age, birth weight, gestational age, and decreasing inner retinal layers (all P < 0.001).Conclusions: Foveal development is dynamic and partially observed through semi-automated analysis of handheld SS-OCT imaging. Translational Relevance: Semi-automated analysis of SS-OCT images can identify measures of foveal maturity.