The Results of Morphometric Assessment of the Macular Zone in Congenital Cataract

Purpose: to study the morphological characteristics of the macular zone using optical coherence tomography to assess its development in congenital cataract. Patients and methods: a comprehensive ophthalmological examination was performed in 147 children (269 eyes) aged 1 to 15 years, including, along with traditional methods, optical coherence tomography on the Spectralis HRA + OCT instrument, Heidelberg Engineering. Of these, 193 eyes were with pseudophakia after the removal of congenital cataracts in children aged 2 months to 14 years, 18 eyes with aphakia after the removal of congenital cataracts in children aged 2 months to 11 years, 20 unoperated eyes with partial forms of congenital cataracts and 38 paired conditionally healthy eyes in children with unilateral congenital cataracts. Visual evaluation of linear tomograms, measurement of 5 parameters of the central zone of the fundus and calculation of the macular index were performed. Results: various features of the macular zone were revealed: changes in the macular contour, lamellar structure of the retina, thinning of the choroid, and elements of epiretinal fibrosis. Evaluation of retinal differentiation with the help of a macular index, calculated on the basis of morphometric characteristics, revealed its violations in 52.8 % of cases, which was not always revealed in the visual analysis of tomograms. The best morphometric parameters of the central zone of the fundus are noted in the eyes with pseudophakia in comparison with aphakia (p < 0.05). Conclusion: there is a variability in the state of the macula. In patients with congenital cataracts. Better indicators of the central zone of the fundus in front of the eye with pseudophakia in comparison with aphakia justify the feasibility of performing surgical treatment of congenital cataracts simultaneously with the implantation of the intraocular lens, including in infants. Thinning of the choroid in the subfoveiolar zone with congenital cataract may indicate a violation of trophism and exert additional influence on the physiological development of the macular zone.

1. Isenberg S.J. Macular development in the premature infant. Am J Ophthalmol. 1986; 1: 74–80.

2. Лопашов Г.В., Строева О.Г. Развитие глаза в свете экспериментальных исследований. [Lopashov G.V., Stroeva O.G. Development of the eye in the light of experimental studies. Moscow, 1963 (In Russ.)]

3. Катаргина Л.А., Рудницкая Я.Л., Коголева Л.В., Рябцев Д.И. Формирование макулы у детей с ретинопатией недоношенных по данным оптической когерентной томографии. Российский офтальмологический журнал. 2011;4(4):30–33. [Katargina L.А., Rudnitskaya Ya.L., Кogoleva L.V., Rjabcev D.I. Macula formation in children with retinopathy of prematurity according to optical coherence tomography. Russian ophthalmological journal = Rossiyskiy oftal’mologicheskiy zhurnal. 2011;4(4):30–33 (In Russ.)]

4. Mori T., Sugano Y., Maruko I., Sekiryu T. Subfoveal Choroidal Thickness and Axial Length in Preschool Children with Hyperopic Anisometropic Amblyopia. Curr Eye Res. 2015;40(9):954–961. DOI: 10.3109/02713683.2014.964418

5. Read S.A., Collins M.J., Vincent S.J., Alonso-Caneiro D. Choroidal thickness in childhood. Invest Ophthalmol Vis Sci. 2013;54(5):3586–3593. DOI: 10.1167/iovs.1311732

6. Read S.A., Collins M.J., Vincent S.J., Alonso-Caneiro D. Macular retinal layer thickness in childhood. Retina. 2015;35(6):1223–33. DOI: 10.1097/ IAE.0000000000000464

7. Tick S., Rossant F., Ghorbel I., Gaudric A., Sahel J.A., Chaumet-Riffaud P., Paques M. Foveal shape and structure in a normal population. Invest Ophthalmol Vis Sci. 2011;52(8):5105–5110. DOI: 10.1167/iovs.10-7005

8. Vinekar A., Avadhani K., Sivakumar M., Mahendradas P., Kurian M., Braganza S., Shetty R., Shetty B.K. Understanding clinically undetected macular changes in early retinopathy of prematurity on spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2011;52(8):5183–5188. DOI: 10.1167/iovs.10-7155

9. Wu S.Q., Zhu L.W., Xu Q.B., Xu J.L., ZhangY. Macular and peripapillary retinal nerve fiber layer thickness in children with hyperopic anisometropic amblyopia. Int J Ophthalmol. 2013;6(1):85–89. DOI: 10.3980/j.issn.2222-3959.2013.01.18

10. Aubakirova A.Zh., Keykina L.K. Study of the macular zone in children with congenital cataracts. [Proceedings of the scientific conference devoted to the 100th anniversary of the birth of Academician N.A. Puchkovskaya «Modern aspects of the clinic, diagnostics and treatment of eye diseases»]. Odessa, 2008;253–254 (In Ukr.)]

11. Л.А. Катаргина, Т.Б. Круглова, Н.С. Егиян, О.Б. Трифонова. Состояние маку лярной зоны сетчатки у детей с артифакией после хирургического лечения односторонних врожденных катаракт. Российский офтальмологический журнал. 2016;9(4):16–21. [Katargina L.A., Kruglova N.S., Egiyan O.B. The state of the macular zone of the retina in children with pseudophakia after surgical treatment of unilateral congenital cataracts. Russian ophthalmological journal = Rossiyskiy oftal’mologicheskiy zhurnal. 2016;9(4):16–21 (In Russ.)]

12. Катаргина Л.А., Круглова Т.Б., Мазанова Е.В., Егиян Н.С., Трифонова О.Б. Состояние макулы по данным оптической когерентной томографии у детей с врожденными катарактами. Российская педиатрическая офтальмология. 2014;3:63. [Katargina L.A., Kruglova T.B., Mazanova E.V., Egiyan N.S., Tri fonova O.B. The state of the macula by optical coherence tomography in children with congenital cataracts. Sostoyanie makuly po dannym opticheskoy kogerentnoy tomografii u detey s vrozhdennymi kataraktami. Russian Pediatric Ophthalmology = Rossiyskaya pediatricheskaya oftal’mologiya. 2014;3:63 (In Russ.)]

13. Kim Y.W., Kim S.J., Yu Y.S. Spectral-domain optical coherence tomography analysis in deprivational amblyopia: a pilot study with unilateral pediatric cataract patients. Graefes Arch Clin Exp Ophthalmol. 2013;251(12):2811–2819. DOI: 10.1007/s00417013-2494-1

14. Sacchi M., Serafino M., Trivedi R.H., Specchia C., Alkabes M., Gilardoni F., Nucci P. Spectral-domain optical coherence tomography measurements of central foveal thickness before and after cataract surgery in children. J Cataract Refract Surg. 2015;41(2):382–386. DOI: 10.1016/j.jcrs.2014.05.047

15. Wang J., Smith H.A., Donaldson D.L., Haider K.M., Roberts G.J., Sprunger D.T., Neely D.E., Plager D.A. Macular structural characteristics in children with congenital and developmental cataracts. J AAPOS. 2014;18(5):417–422. DOI: 10.1016/j.jaapos.2014.05.008