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Visual outcome in infants with cicatricial retinopathy of prematurity
1Anderson Vision Research Center, Retina Foundation of the Southwest, Dallas, TX 75231.
Insights
Vision testing in preterm infants with retinopathy of prematurity (ROP) using preferential-looking (FPL) showed reduced grating acuity. Early FPL acuity tests may predict long-term visual outcomes in infants with ROP.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Developmental Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Accurate assessment of visual acuity in this population is crucial for monitoring disease progression and treatment efficacy.
- Traditional methods for visual acuity testing can be challenging in very young infants.
Purpose of the Study:
- To evaluate monocular grating acuities in preterm infants diagnosed with retinopathy of prematurity (ROP).
- To correlate visual acuity measurements with the anatomical outcomes of ROP.
- To assess the predictive value of early forced-choice preferential-looking (FPL) acuity tests for long-term functional vision.
Main Methods:
- Monocular grating acuities were measured using a forced-choice preferential-looking (FPL) procedure in preterm infants with ROP.
- Eyes were graded by retinal specialists into anatomic outcome categories based on cicatricial residua of ROP.
- Comparison was made between infants with normal/regressed ROP and those with more severe forms (macular ectopia, detachment).
Main Results:
- Infants with normal/regressed ROP and normal posterior poles showed slightly lower grating acuities than age-matched healthy full-term infants.
- Grating acuity in eyes with abnormal posterior poles (macular ectopia, detachment) was significantly related to the anatomic outcome category (P < 0.001).
- Early FPL acuity tests demonstrated a strong correlation (r = 0.75-0.87) with long-term functional visual outcomes at follow-up intervals of 6 months to 2-5 years.
Conclusions:
- Preterm infants with ROP exhibit reduced grating acuities, even in cases with seemingly normal posterior pole anatomy.
- The severity of anatomical changes in ROP directly impacts grating acuity measurements.
- Early FPL testing in infants with ROP is a valuable tool for predicting future visual function, aiding in early intervention strategies.
Abstract:
Monocular grating acuities of preterm infants with retinopathy of prematurity (ROP) were measured using a forced-choice preferential-looking (FPL) procedure. Eyes were independently graded by a retinal specialist and/or pediatric ophthalmologist and assigned to anatomic outcome categories on the basis of cicatricial residua of ROP. Eyes assigned to the normal/regressed and peripheral retinal changes categories (n = 120) had normal posterior poles. The authors found that grating acuities in this group were slightly lower than those of age-matched healthy full-term infants, even when infants with amblyogenic or neurologic conditions were eliminated from the analysis. Grating acuity of eyes assigned to the macular ectopia, macular fold, partial detachment, or total detachment outcome categories (n = 60) had abnormal posterior poles, and grating acuity of these eyes was significantly related to anatomic outcome category (P less than 0.001). Follow-up data from subsets of eyes at 6 months, 12 months, or 2-5 yr after the initial acuity test suggest that early FPL acuity tests may be predictive of long-term functional outcome (r = 0.75-0.87).