Foveal microvascular anomalies on optical coherence tomography angiography and the correlation with foveal thickness and visual acuity in retinopathy of prematurity

  • Yen-Chih Chen
  • Yan-Ting Chen
  • San-Ni ChenEmail author
Retinal Disorders



To assess foveal microvascular structure and the correlation between foveal retinal thickness and best corrected visual acuity (BCVA) in children with retinopathy of prematurity (ROP).


This is a retrospective case-control study. A total 42 eyes in 23 patients with history of anti-vascular endothelial factor (VEGF) agent treatment and 51 eyes of 27 healthy age-matched subjects as the control group were analyzed. Foveal avascular zone (FAZ) and foveal vessel density (VD) were measured by optical coherence tomography angiography (OCT-A). Foveal thickness was measured by cross-sectional OCT. Correlations between FAZ area, foveal VD, foveal thickness, BCVA, gestational age (GA), and birth body weight (BBW) were performed.


ROP children had a significantly smaller FAZ area and higher foveal VD, and the foveal thickness was significantly higher as compared to controls (all P < 0.0001). We noted a significant negative correlation between FAZ area and foveal thickness. In addition, a significant positive correlation between foveal VD and foveal thickness was identified. With regard to prematurity status, gestational age and birth body weight were both significantly correlated with FAZ area, foveal VD, and fovea inner retinal thickness. Multivariable analysis showed that thicker inner retinal thickness and higher superficial vascular density were associated with suboptimal visual acuity.


By using OCT-A, we identified significant foveal microvascular anomalies in ROP children. The correlation between the microvascular anomalies, central foveal thickness, and suboptimal visual acuity was also noted. Because of the retrospective nature, more studies are necessary to further establish the relationship.


Anti-vascular endothelial growth factor Foveal avascular zone Foveal thickness Optical coherent tomography angiography Retinopathy of prematurity 



No funding was received for this research.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. The study was approved by the Institutional Review Board of the hospital and was conducted in accordance with the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of ophthalmologyChanghua Christian HospitalChanghua CityTaiwan
  2. 2.Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Department of OptometryCentral Taiwan University of Science and TechnologyTaichungTaiwan
  4. 4.School of MedicineChung-Shan Medical UniversityTaichungTaiwan
  5. 5.School of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
  6. 6.Department of OptometryDa-Yeh UniversityChanghuaTaiwan

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