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Response to: Optical coherence tomography biomarkers in preterm infants with and without retinopathy of prematurity: fallacies and facts

Eye (2024)Cite this article

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Thank you for the opportunity to respond to interesting queries raised through the letter, optical coherence tomography biomarkers in preterm infants with and without retinopathy of prematurity: fallacies and facts [1]. We thank the authors for their deep interest in the subject of our recently published article titled “Evaluating the optical coherence tomography (OCT) biomarkers to differentiate favorable and unfavorable responders to anti-vascular endothelial growth factor (anti-VEGF) in retinopathy of prematurity (ROP)” [2].

The hyperreflectivity described in our published article shows the complete hyperreflectivity of not just one or two layers but of all the six inner retinal layers (Figs. 1 and 2). All these six retinal layers are also disorganized and cannot be delineable from each other. This finding is due to the ischemic load involving full thickness of the retina in aggressive retinopathy of prematurity (A-ROP) eyes and has never been reported before. This hyperreflectivity coupled with disorganization of retinal layers is very similar to the OCT lesions seen in adult eyes in conditions such as ischemic central retinal vein occlusion, impending central retinal artery occlusion, or ischemic diabetic macular oedema [4, 5].

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Fig. 1: Simultaneous ultra-wide field swept-source OCT with ultra-wide field fundus photo.
Fig. 2: Simultaneous ultra-wide field swept-source OCT with ultra-wide field fundus photo.

Data availability

Data set are available with author Akash Belenje and at ROP database office at LV Prasad Eye Institute, Hyderabad, Telangana, India-500034.

References

  1. Vinekar A, Mangalesh S. Optical coherence tomography biomarkers in preterm infants with and without retinopathy of prematurity: fallacies and facts. EYE. 2024 [IN PRESS].

  2. Belenje A, Reddy RU, Parmeswarappa DC, Padhi TR, Subbarao B, Jalali S. Evaluation of optical coherence tomography biomarkers to differentiate favourable and unfavourable responders to intravitreal anti-vascular endothelial growth factor treatment in retinopathy of prematurity. Eye (Lond). 2023. https://doi.org/10.1038/s41433-023-02824-1.

  3. Mangalesh S, McGeehan B, Tai V, Chen X, Tran-Viet D, Vajzovic L, et al. Macular OCT characteristics at 36 weeks’ postmenstrual age in infants examined for retinopathy of prematurity. Ophthalmol Retin. 2021;5:580–92.

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  4. Furashova O, Matthè E. Hyperreflectivity of inner retinal layers as a quantitative parameter of ischemic damage in acute retinal vein occlusion (RVO): an Optical Coherence Tomography study. Clin Ophthalmol. 2020;14:2453–62. https://doi.org/10.2147/OPTH.S260000

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  5. Huang YT, Chang YC, Meng PP, Lin CJ, Lai CT, Hsia NY, et al. Optical coherence tomography biomarkers in predicting treatment outcomes of diabetic macular edema after dexamethasone implants. Front Med. 2022;9:852022 https://doi.org/10.3389/fmed.2022.852022

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  6. Vinekar A, Avadhani K, Sivakumar M, Mahendradas P, Kurian M, Braganza S, et al. Understanding clinically undetected macular changes in early retinopathy of prematurity on spectral domain optical coherence tomography. Investig Ophthalmol Vis Sci. 2011;52:5183–8.

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Funding

Hyderabad Eye Research Foundation (2020), Hyderabad, India. The institute has received funding or support for its ongoing Retinopathy of Prematurity programs from Miriam Hyman Memorial Trust (MHMT, UK), Dalmia Holdings (India), Queen Elizabeth Diamond Jubilee Trust (UK), Public Health Foundation of India, Cognizant Foundation and the Government of India.

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Authors and Affiliations

  1. Srimati Kanuri Santhamma Center for Vitreo Retinal Diseases, Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India

    Akash Belenje & Subhadra Jalali

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  1. Akash Belenje
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  2. Subhadra Jalali
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Contributions

Akash Belenje and Subhadra Jalali: wrote the reply to letter to editor, Devised and designed the study, devised data collection protocol and data analysis, literature search, and wrote the manuscript.

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Correspondence to Subhadra Jalali.

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The authors declare no competing interests.

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IRB approved with ethics number LEC-BHR-P-09-22-926.

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Belenje, A., Jalali, S. Response to: Optical coherence tomography biomarkers in preterm infants with and without retinopathy of prematurity: fallacies and facts. Eye (2024). https://doi.org/10.1038/s41433-024-03062-9

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