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Optical coherence tomography findings in stage 4A retinopathy of prematurity: a theory for visual variability
Mandar M Joshi1, Michael T Trese, Antonio Capone
1Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan, USA.
Purpose:
To report macular anatomic abnormalities in eyes with stage 4A retinopathy of prematurity (ROP) that may account for poor visual outcome despite an ophthalmoscopically normal-appearing posterior pole.
Design:
Retrospective case series.
Participants:
Nine patients (14 eyes).
Methods:
Nine patients (14 eyes) diagnosed with stage 4A retinal detachments were imaged with optical coherence tomography (OCT) before repair by lens-sparing pars plana vitrectomy. One patient (2 eyes) 2 years after successful lens-sparing vitrectomy for stage 4A detachment with reduced visual acuity underwent fluorescein angiography, fundus photography, and imaging with OCT.
Main Outcome Measure:
Optical coherence tomography findings.
Results:
Preoperative OCT confirmed absence of macular involvement in 12 of 14 eyes. Two eyes demonstrated diffuse intraretinal posterior pole changes. Both eyes of a 2-year-old infant demonstrated a lack of normal foveal architecture on OCT scanning and an absent foveal avascular zone on angiography.
Conclusions:
Anatomic macular abnormalities--not immediately apparent ophthalmoscopically--may explain the variability in visual outcome after lens-sparing vitrectomy for stage 4A ROP.
