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Invited Commentary
July 2018

Why Do We Still Rely on Ophthalmoscopy to Diagnose Retinopathy of Prematurity?

Author Affiliations
  • 1Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
JAMA Ophthalmol. 2018;136(7):759-760. doi:10.1001/jamaophthalmol.2018.1539

There was a time not that long ago when there was equipoise as to whether optical coherence tomography (OCT) could complement the clinical examination in a meaningful way and whether it justified the time and expense for practices focused on adult patients with retinal conditions. In 2018, OCT has become standard equipment and has a critical role in the diagnosis and monitoring of many vitreoretinal diseases. The recent development of OCT angiography (OCTA) may further enhance clinical care. Management paradigms based on OCT have become standard of care for neovascular age-related macular degeneration and diabetic macular edema, 2 of the leading causes of blindness and vision impairment in adults. However, OCT has yet to become mainstream in the management of pediatric vitreoretinal diseases. Even in the most common pediatric retinal disease, retinopathy of prematurity (ROP), the use of imaging technologies generally and OCT and OCTA in particular lags behind adult diseases, despite compelling evidence that these technologies could improve our clinical care.1,2

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