Evaluation of Hyaloid Artery Persistence as a Biomarker in Retinopathy of Prematurity Using OCT.

Objective: To evaluate whether hyaloid artery persistence, detected by handheld OCT, is associated with retinopathy of prematurity (ROP) severity. Design: A retrospective cohort study. Subjects: A total of 162 eyes of preterm infants undergoing ROP screening at a tertiary care neonatal intensive care unit were included. Methods: Handheld ultra-widefield OCT images were reviewed at each clinical encounter for the presence or absence of the hyaloid artery. Time to hyaloid artery disappearance was modeled using a Weibull accelerated failure time survival analysis incorporating interval censoring and clustering within subjects. Covariates included ROP severity (mild, moderate, or severe) and gestational age (GA). Leave-one-eye-out cross-validated area under the receiver operating characteristic curves (AUROCs) were calculated to evaluate the discriminative ability of hyaloid regression timing for ROP severity. Main Outcome Measures: The primary outcomes were postnatal age (PNA) at hyaloid artery disappearance and AUROC values for No vs. Mild, No vs. Severe, and Mild vs. Severe ROP. Results: The hyaloid artery was detectable by OCT in 152 of 162 (94%) eyes. Compared with eyes with No ROP, hyaloid artery persistence was significantly prolonged in Mild ROP (acceleration factor [AF], 1.354; Conclusions: The hyaloid artery is commonly detectable in preterm infants using OCT. Persistence of the hyaloid artery is significantly associated with increasing ROP severity and may serve as a novel, quantifiable biomarker of disease severity and retinal maturation. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.