High-Resolution Characterization of Cone Photoreceptor Mosaic Alterations in Retinopathy of Prematurity Using Adaptive Optics Scanning Laser Ophthalmoscopy
- 1Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
- 2Center for Preventative Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Abstract
Purpose
To characterize cone photoreceptor alterations using adaptive optics scanning laser ophthalmoscopy (AO-SLO) and explore their relationships with retinal structure, visual function, and ocular biometry in children with retinopathy of prematurity (ROP).Design
Prospective observational case series.Participants
A total of 313 eyes from 162 children were included, comprising full-term controls, preterm children without ROP, children with regressed ROP, and children with ROP treated with laser photocoagulation (LP), intravitreal anti-VEGF therapy, or combined therapy.Methods
Participants underwent AO-SLO, swept-source OCT, best-corrected visual acuity testing, and ocular biometry. Cone density, dispersion, and regularity were evaluated across retinal regions. Between-group interpretation emphasized temporal cone metrics, and secondary exploratory analyses evaluated associations with retinal structural, visual, and biometric parameters.Main outcome measures
Adaptive optics SLO-derived cone density, cone dispersion, and cone regularity across retinal regions, with temporal cone metrics considered the main region of interest.Results
Among the clinically defined ROP subgroups, overall group differences in cone metrics were identified predominantly in the temporal region after multivariable adjustment (P < 0.05). In Bonferroni-adjusted pairwise comparisons, the LP + intravitreal injection clinical-background group showed lower temporal cone regularity than preterm children without ROP (94.5% vs. 96.4%; adjusted mean difference, -1.92%; Bonferroni-adjusted P=0.001), whereas temporal cone density and dispersion showed similar directional but nonsignificant pairwise differences. Laser-treated eyes showed greater inner retinal thickness (IRT) in selected regions (P ≤ 0.006). Temporal cone regularity showed a weak positive association with temporal IRT (r = 0.10, generalized estimating equation-derived P=0.046; Table S6), whereas broader correlations between AO-SLO parameters and OCT measurements were generally limited.Conclusions
Adaptive optics SLO identified selective temporal cone photoreceptor mosaic alterations in children with ROP, most consistently reflected by reduced temporal cone regularity, with directional differences in cone density and dispersion. These findings extend prior AO observations in ROP to a larger pediatric cohort and support AO-SLO as a complementary modality for evaluating cone spatial organization in ROP survivors.Financial disclosures
The author has no/the authors have no proprietary or commercial interest in any materials discussed in this article.
Related
- Investigation on the impact of outdoor exercise on retinal cone photoreceptor mosaic using adaptive optics scanning laser ophthalmoscopy
- Explainability-informed patient-disjoint evaluation of deep learning for plus disease in retinopathy of prematurity with an ophthalmologist reader study
- Predicting Retinopathy of Prematurity in Thailand: A Practical Model for Risk-Based Screening
- Neurodevelopmental Disorders in Infants Treated with Anti-VEGF Agents versus Laser Photocoagulation or Cryotherapy for Retinopathy of Prematurity
- Reduced serum Dickkopf-1 levels as a potential supportive biomarker for the development and severity of retinopathy of prematurity: a prospective observational clinical study
BibTeX
@article{liu2026highresolution,
title = {{High-Resolution Characterization of Cone Photoreceptor Mosaic Alterations in Retinopathy of Prematurity Using Adaptive Optics Scanning Laser Ophthalmoscopy}},
author = {Yaling Liu and Jiannan Tang and Xinyu Zhao and Yarou Hu and Ziying Zhou and Zhen Yu and Xiayuan Luo and Mianying Zheng and Guishuang Ying and Guoming Zhang},
journal = {Ophthalmology science},
year = {2026},
month = sep,
doi = {10.1016/j.xops.2026.101412},
url = {https://europepmc.org/article/PMC/PMC13717863},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - High-Resolution Characterization of Cone Photoreceptor Mosaic Alterations in Retinopathy of Prematurity Using Adaptive Optics Scanning Laser Ophthalmoscopy
AU - Yaling Liu
AU - Jiannan Tang
AU - Xinyu Zhao
AU - Yarou Hu
AU - Ziying Zhou
AU - Zhen Yu
AU - Xiayuan Luo
AU - Mianying Zheng
AU - Guishuang Ying
AU - Guoming Zhang
PY - 2026
DA - 2026/09/21
JO - Ophthalmology science
DO - 10.1016/j.xops.2026.101412
UR - https://europepmc.org/article/PMC/PMC13717863
AB - Purpose To characterize cone photoreceptor alterations using adaptive optics scanning laser ophthalmoscopy (AO-SLO) and explore their relationships with retinal structure, visual function, and ocular biometry in children with retinopathy of prematurity (ROP).Design Prospective observational case series.Participants A total of 313 eyes from 162 children were included, comprising full-term controls, preterm children without ROP, children with regressed ROP, and children with ROP treated with laser photocoagulation (LP), intravitreal anti-VEGF therapy, or combined therapy.Methods Participants underwent AO-SLO, swept-source OCT, best-corrected visual acuity testing, and ocular biometry. Cone density, dispersion, and regularity were evaluated across retinal regions. Between-group interpretation emphasized temporal cone metrics, and secondary exploratory analyses evaluated associations with retinal structural, visual, and biometric parameters.Main outcome measures Adaptive optics SLO-derived cone density, cone dispersion, and cone regularity across retinal regions, with temporal cone metrics considered the main region of interest.Results Among the clinically defined ROP subgroups, overall group differences in cone metrics were identified predominantly in the temporal region after multivariable adjustment (P < 0.05). In Bonferroni-adjusted pairwise comparisons, the LP + intravitreal injection clinical-background group showed lower temporal cone regularity than preterm children without ROP (94.5% vs. 96.4%; adjusted mean difference, -1.92%; Bonferroni-adjusted P=0.001), whereas temporal cone density and dispersion showed similar directional but nonsignificant pairwise differences. Laser-treated eyes showed greater inner retinal thickness (IRT) in selected regions (P ≤ 0.006). Temporal cone regularity showed a weak positive association with temporal IRT (r = 0.10, generalized estimating equation-derived P=0.046; Table S6), whereas broader correlations between AO-SLO parameters and OCT measurements were generally limited.Conclusions Adaptive optics SLO identified selective temporal cone photoreceptor mosaic alterations in children with ROP, most consistently reflected by reduced temporal cone regularity, with directional differences in cone density and dispersion. These findings extend prior AO observations in ROP to a larger pediatric cohort and support AO-SLO as a complementary modality for evaluating cone spatial organization in ROP survivors.Financial disclosures The author has no/the authors have no proprietary or commercial interest in any materials discussed in this article.
SN - 2666-9145
ER -