Visual Acuity, Optical Components, and Macular Abnormalities in Patients with a History of Retinopathy of Prematurity

doi:10.1016/j.ophtha.2012.02.040

Ophthalmology

Volume 119, Issue 9, September 2012, Pages 1907-1916

https://doi.org/10.1016/j.ophtha.2012.02.040 Get rights and content

Purpose

To examine the optical components and spectral-domain optical coherence tomography (OCT) findings in children with a history of retinopathy of prematurity (ROP) and to identify any associations between the OCT findings and the visual acuities of the patients.

Design

Prospective, case-controlled study.

Participants and Controls

Children who were between 6 and 14 years of age were divided into the following 4 groups: Patients with a history of threshold ROP who had been treated using laser therapy or cryotherapy (group 1), patients with regressed ROP who had not received any treatment (group 2), patients who were born prematurely but who had no history of ROP (group 3), and normal full-term children (group 4). The posterior poles of the eyes of all of the patients seemed to be normal.

Methods

Visual acuities, optical components, and macular thicknesses were measured in 4 groups of patients, and comparisons between the groups were made. Macular thicknesses were measured using OCT.

Main Outcome Measures

Visual acuity (VA), optical components, and OCT findings.

Results

We enrolled 133 patients in the study. Patients in group 1 had significantly thicker foveas than the other patients, as demonstrated by OCT, and this finding was negatively correlated with gestational age. The incidence of abnormal foveal contours among patients in group 1 was significantly higher than among the rest of the patients. Retention of the inner retinal layers was noted in group 1 patients; however, the structure of the outer retina remained intact. Greater degrees of myopic shift and astigmatism, steeper corneal curvatures, shallower anterior chamber depths, and thicker lenses were noted in previously treated ROP patients. These findings corresponded with poor VA and high refractive errors in group 1 patients.

Conclusions

Patients with a history of threshold ROP are more likely to show abnormal foveal development and have a poorer visual prognosis than other patient groups despite a fundus with no macular dragging, disc dragging, or retinal detachment. A steeper corneal curvature, shallower anterior chamber, and greater lens thickness are the main changes in the optical components in these patients.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Section snippets

Patients and Grouping

This study was approved by the institutional review board of the Chang Gung Memorial Hospital and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from a parent or guardian of each participant.

This prospective, case-controlled study included children with a previous history of ROP who underwent treatment and were followed at our hospital. All of the patients were Asian. The fundi of all eyes were normal in appearance. Patients were excluded

Results

A total of 133 patients met our screening criteria and completed the examinations. There were 24 in group 1, 18 in group 2, 44 in group 3, and 47 in group 4. The mean GAs of the 4 groups were 25.8±1.4, 28.7±2.0, 31.3±2.6, and 38.1±2.3 weeks, respectively. The mean BWs of the groups were 853.1±222.5, 1129.3±217.1, 1667.3±523.2, and 3036.3±324.4 g, respectively. The mean GA and BW for group 1 were significantly lower than those of the other groups (P<0.0001 and P<0.0001). The mean ages of the

Discussion

In this prospective, case-controlled study, we found that patients with threshold ROP had a significantly steeper corneal curvatures, shallower anterior chamber depths, thicker lenses, and increased macular thicknesses; however, they had normal vitreous depths and axial lengths (Fig 6). These findings were associated with high refractive errors and poorer BCVA in ROP patients who had previously been treated with peripheral ablative procedures. These changes show a gradual progression in

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Cited by (145)

Persistent Vascular Anomalies in Retinopathy of Prematurity Children: Ultrawide-field Fluorescein Angiography Findings until School Age
2023, Ophthalmology Science
To investigate vascular abnormalities, including persistent avascular retina (PAR), in a large cohort of patients with regressed or treated retinopathy of prematurity (ROP) through long-term follow-up until school age.
Retrospective large cohort study.
We included pediatric patients (< 18 years old) with a history of nontreated or treated ROP (treated with either photocoagulation or intravitreal injection [IVI]) and regularly followed up until 2020.
Upon enrollment, we categorized patients into 4 groups: prematurity, regressed ROP, and IVI and laser treatment ROP groups. All patients had undergone visual acuity examinations, OCT, and ultrawide-field fluorescein angiography.
Percentage of eyes with PAR (greater than or equal to the area of 2 disc diameters from the ora serrata to vascular termini) and with vascular abnormalities in the peripheral and posterior retina.
In total, we included 187 eyes of 95 patients. The prevalence of PAR was 0%, 33.33%, and 31.65% in eyes in the prematurity, regressed ROP, and IVI treatment groups, respectively (P < 0.0001). There was no significant difference in the percentage of PAR eyes when comparing regressed ROP group (33.33%) with the IVI treatment group (31.65%). At least 1 type of vascular abnormality was noted until school age in all (100%) treated ROP eyes. Although multivariate analysis found a significant association between IVI treatment and PAR (odds ratio: 10.28, 95% confidence interval: 3.29–32.14) until the school age of 6 to 8 years old, there were no stage 3 eyes in the spontaneously regressed group, suggesting that stage 3 ROP in the IVI group could also drive the association.
Approximately one-third of ROP eyes with spontaneous regression or IVI treatment still exhibit PAR when the child reaches school age. Several distinct vascular anomalies at the vascular–avascular juncture and within the vascularized retina can persist in these children. The clinical significance of these anomalies and the decision whether to treat them warrant further investigation to optimize their outcomes.
The authors have no proprietary or commercial interest in any materials discussed in this article.
A lower birth weight percentile is associated with central corneal thickness thinning: Results from the Gutenberg Prematurity Eye Study (GPES)
2023, Journal of Optometry
Prematurity, prenatal growth restriction, and retinopathy of prematurity (ROP) are associated with altered ocular geometry, such as a steeper corneal shape in childhood, but it is unclear whether perinatal history affects corneal thickness development, so this study investigated whether corneal thickness in adulthood is affected by perinatal history.
The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. The corneal thickness was measured by Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany), and the relationship between perinatal parameters respective birth weight percentile and corneal thickness at different locations was assessed using uni- and multivariable linear regression models. Covariates included age, sex, mean corneal radius, white-to-white distance, gestational age, birth weight percentile, ROP occurrence, and treatment. The main outcome measures were corneal thickness at the apex, the pupil center, and the corneal periphery.
The corneal thickness was measured in 390 participants (754 eyes, mean age 29.7+/-8.7 years, 224 females). In multivariable analyses, a lower birth weight percentile was associated with a lower corneal thickness at the apex (B = 0.20, p = 0.003) and the pupil (B = 0.19, p = 0.007). These effects diminished towards the corneal periphery and were not observed beyond the 4-mm diameter circle around the thinnest corneal position. Neither gestational age, ROP occurrence, or ROP treatment affected the corneal thickness.
A lower birth weight percentile in subjects born preterm as a proxy for restricted fetal growth is associated with corneal thickness thinning in adults aged 18 to 52 years, indicating that corneal thickness development, particularly in the corneal center, may originate in the fetal stage.
Association of birth weight with corneal aberrations in adulthood – Results from a population-based study
2023, Journal of Optometry
Low birth weight (BW) is associated with increased corneal aberrations in childhood and alterations of corneal geometry in adulthood. Increased corneal aberrations may be a factor contributing to decreased visual function in former low BW newborns in later life. Hence, the aim of this study was to analyze the long-term effect of low BW on corneal aberrations in adulthood.
In the German population-based Gutenberg Health Study (GHS) participants (age: 40–80 years) were examined with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). The relationship between self-reported BW and the different types of corneal aberrations was analyzed using linear regression analysis as uni- and multivariable analysis with adjustment for potential confounders. The main outcome measures were corneal aberrations defined as astigmatism (Z₂⁻²; Z₂²), coma (Z₃⁻¹; Z₃¹), trefoil (Z₃⁻³; Z₃³), spherical aberration (Z₄⁰) and root-mean square of higher order aberrations (HOA; 3rd up to 8th order; aperture size: 6 mm).
Overall, 5,628 participants were included in this analysis (3,004 women, aged 56.0 +/- 10.3 years). In a multivariable analysis lower BW was associated with decreased horizontal trefoil (B = 0.004 [0.001; 0.006] µm/500 g; p=.008); higher spherical aberrations (B=-0.006 [-0.008;-0.003] µm/500 g; p<.001), higher RMS (B=-0.028 [-0.042;-0.014] µm/500 g; p<.001), increased HOA (B=-0.007 [-0.010;-0.003] µm/500 g; p<.001) and increased LOA (B=-0.027 [-0.041;-0.013] µm/500 g; p<.001). No association was observed between birth weight and the other types of corneal aberrations in multivariable model.
Our results indicate an association between BW and spherical aberration in adults aged 40 to 80 years. This indicates that low BW may have an association with an altered corneal shape development which may affect optical image quality and, hence, visual function.
Macular thickness variation and interocular symmetry by gestational age in preterm school-age children
2022, Journal of AAPOS
To determine changes in macular thickness profile according to gestational age (GA) and to assess interocular symmetry in the macula of children born very preterm.
In this cross-sectional study of preterm (n = 106) and term-born (n = 49) children 5-8 years of age at time of examination, optical coherence tomography was used to measure macula thickness as described in the ETDRS study. Statistical analyses included stratified and multivariable analyses.
Foveal minimum thickness increased with decreasing GA (P for trend, <0.001; 254.7 ± 32.8 μm for children born at 24-25 weeks and 193.2 ± 32.8 μm in term-born children). Inner and outer area thickness differed for term and preterm children, but did not vary with the degree of prematurity (inner area, 267.0 ± 11.0 μm for 24-25 weeks’ GA and 305.4 ± 11.8 μm for term children [P < 0.01]; outer ring, 305.5 ± 10.4 μm in extreme preterm and 271.0 ± 10.4 μm in term children [P < 0.01]). Interocular asymmetry in preterm children was not significant for most areas; the largest interocular difference was found in the central zone (16.3 ±16.6 μm).
In our study cohort, children born very preterm examined at school age compared to term born children had greater central thickness with decreased foveal pit, decreased inner ring, and increased thickness of the outer ring. They did not show greater interocular asymmetry.
Ophthalmic sequelae of prematurity in late childhood and adulthood: A review
2024, Clinical and Experimental Ophthalmology
A bibliometric analysis and visualization of retinopathy of prematurity from 2001 to 2021
2024, European Review for Medical and Pharmacological Sciences

View all citing articles on Scopus

: Manuscript no. 2011-1241.

: Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. Partially supported by a Chang Gung Memorial Hospital Research Grant (CMRPG3A0391) and a National Science Council Research Grant (NSC98-231-B-182A-001-MY2).

View full text

Original articleVisual Acuity, Optical Components, and Macular Abnormalities in Patients with a History of Retinopathy of Prematurity

Purpose

Design

Participants and Controls

Methods

Main Outcome Measures

Results

Conclusions

Financial Disclosure(s)

Section snippets

Patients and Grouping

Results

Discussion

J AAPOS

Ophthalmology

Ophthalmology

Ophthalmology

Am J Ophthalmol

Ophthalmology

Am J Ophthalmol

Ophthalmology

Ophthalmology

Ophthalmology

Ophthalmology

Glaucoma as a cause of poor vision in severe retinopathy of prematurity

Graefes Arch Clin Exp Ophthalmol

The aetiology of paediatric rhegmatogenous retinal detachment: 15 years experience

Eye (Lond)

Long-term visual outcomes of laser-treated threshold retinopathy of prematurity: a study of refractive status at 7 years

Eye (Lond)

Cataract extraction in adults with retinopathy of prematurity

Arch Ophthalmol

Adult retinopathy of prematurity: retinal complications from cataract surgery

Am J Ophthalmol

Retinopathy of prematurity: late complications in the baby boomer generation (1946-1964)

Trans Am Ophthalmol Soc

Optical coherence tomography imaging of the fovea in retinopathy of prematurity

Ophthalmic Surg Lasers Imaging

Foveal fine structure in retinopathy of prematurity: an adaptive optics Fourier domain optical coherence tomography study

Invest Ophthalmol Vis Sci

Stratus optical coherence tomography findings in patients with retinopathy of prematurity

Arq Bras Oftalmol

Original article
Visual Acuity, Optical Components, and Macular Abnormalities in Patients with a History of Retinopathy of Prematurity